Maintenance of blood pressure control and left ventricular performance with small doses of enalapril

Enalapril treatment (20 mg every 12 hours) of 24 patients with essential hy pertension and left ventricular (LV) hypertrophy established normal blood p ressure (BP) after 8 weeks, and after 7 years had reduced LV mass index by 39% from 148 +/- 34 to 90 +/- 16 g/m(2), and had normalized LV structure an d function and QT dispersion. Stepwise reduction of the enalapril dosage fr om 40 to 30, 20, 10, and 5 mg/day during the eighth year caused no signific ant changes in BP, LV structure, LV systolic function, or QT dispersion, wh ich all likewise remained unaltered during a further year of the 5-mg/day r egimen. We conclude that for hypertensive patients in whom prolonged treatm ent with standard doses of enalapril has normalized BP, LV structure and fu nction, and QT dispersion, significantly smaller doses are sufficient to ma intain these cardiovascular achievements. (C)1999 by Excerpta Medica, Inc.