EFFECTS OF LONG-TERM ANTIHYPERTENSIVE TREATMENT WITH LISINOPRIL ON RESISTANCE ARTERIES IN HYPERTENSIVE PATIENTS WITH LEFT-VENTRICULAR HYPERTROPHY

Objective To evaluate the effects of long-term antihypertensive therap y with the angiotensin converting enzyme inhibitor lisinopril on struc tural alterations and the endothelial function of small resistance art eries in hypertensive patients with left ventricular hypertrophy. Meth ods Fourteen patients with left ventricular hypertrophy were treated f or 3 years with a lisinopril-based regimen, Patients underwent an echo cardiographic evaluation of left ventricular mass index at baseline, d uring the first and third years of treatment. At the end of the treatm ent period, subcutaneous small resistance arteries (obtained by biopsy of the subcutaneous fat from the gluteal region) were dissected and m ounted on a micromyograph (Mulvany's technique); the media:lumen ratio was then calculated, Data obtained were compared with those observed for 14 untreated essential hypertensive patients and 14 normotensive s ubjects, age- and sex-matched. Results In the present study, a signifi cantly lower media: lumen ratio was observed in treated compared with untreated hypertensive patients, although it remained significantly hi gher than that in normotensive subjects, In treated hypertensive patie nts a significant reduction in clinic blood pressure was observed. How ever, their blood pressure remained significantly higher than that in normotensive subjects, Significant correlations between the media:lume n ratio and blood pressure, left ventricular mass index or changes in left ventricular mass index during treatment were observed, The respon se to acetylcholine administration was reduced in untreated hypertensi ves compared with that in normotensives. In patients treated with lisi nopril, the vasodilatation obtained with the two higher doses of acety lcholine was greater than that in untreated hypertensives, thus sugges ting an improvement of endothelial function. Conclusions Long-term the rapy based on lisinopril was associated with a smaller media:lumen rat io in the subcutaneous small resistance arteries of hypertensive patie nts with left ventricular hypertrophy, Our retrospective study confirm s previous findings obtained in prospective studies with other angiote nsin converting enzyme inhibitors, Endothelial function was probably i mproved by lisinopril therapy. (C) Rapid Science Publishers.