HEMODYNAMIC AND BIOCHEMICAL-CHANGES AFTER CHRONIC ADMINISTRATION OF CILAZAPRIL TO HYPERTENSIVE PATIENTS

The study describes the changes in basic hemodynamic parameters after long-term antihypertensive therapy with cilazapril - a new ACE inhibit or lacking a sulfhydryl group - in hypertensive patients and the drug effects on renal function, glucose tolerance and lipid metabolism. 30 patients (18 males, 12 females, mean age: 53.3 +/- 18 years) with mild to moderate essential hypertension were studied. The following determ inations were performed in patients, before and after 4.5 months of ci lazapril monotherapy at a dose of 5 mg/24 h: (a) antihypertensive acti on of the drug (arterial pressure at rest and during a 24-hour recordi ng); drug effects on left ventricular (LV) mass index; its contractili ty indexes (%FS, EF) and the left atrial emptying index were studied b y means of echocardiography; (b) plasma insulin concentration during o ral glucose tolerance tests, in the fasting state, after the administr ation of 75 g glucose per os, as well as the changes in the insulinoge nic index and the 6-keto-PGF1alpha/TXB2 ratio, and (c) drug effect on renal function (urea, creatinine, uric acid, plasma electrolytes), blo od lipid profile (total cholesterol, triglycerides, HDLCH) and serum t ransaminases. Long-term drug administration exhibits an effective anti hypertensive action, without causing reflex tachycardia and also reduc es the LV mass index without affecting its EF, while improving its dia stolic function. It does not significantly affect the various biochemi cal parameters, and achieves glucose regulation, both in the fasting s tate and after glucose loading, with a decrease in the insulinogenic i ndex, and simultaneously increases the 6-keto-PGF1alpha/TXB2 ratio. Th e existence of a direct cause-effect relationship between the changes in the above hormone systems is possible.