Capillary blood cell velocity in finger nailfold: Effect of enalapril and mibefradil in patients with mild to moderate hypertension

Outpatients with essential hypertension were randomized to receive antihype rtensive treatment with either mibefradil or enalapril. Ambulatory blood pr essure measurement (ABPM) and video capillary microscopy of the finger nail fold were performed at baseline and after 12 weeks of treatment. In the ena lapril group (n = 21) baseline ABP was 156 +/- 12/100 +/- 9 mm Hg and decre ased to 140 +/- 17/89 +/- 10 mm Hg after 12 weeks. In the mibefradil group (n = 22) mean 24-h ABP decreased from 15 +/- 14 /102 +/- 7 to 140 a 10/89 /- 7 mm Hg. Capillary blood cell velocity (CBV) without treatment was 0.90 +/- 0.58 mm/s (mean +/- SD) and 0.83 +/- 0.46 mm/s at rest and 0.30 +/- 0.2 2 and 0.21 +/- 0.20 mm/s immediately after local finger cooling in the mibe fradil and the enalapril group, respectively. In the Enalapril group CBV at week 12 was 0.99 +/- 0.60 mm/s (n.s.) at rest and 0.40 +/- 0.28 mm/s immed iately after local cooling (P = 0.005 compared to 0.21 +/- 0.20 mm/s withou t treatment). Twelve weeks after initiation of treatment CBV was 0.76 +/- 0 .48 mm/s (n.s.) at rest and 0.31 +/- 0.28 mm/s (n.s.) immediately after loc al cooling in the mibefradil group. Finger nailfold CBV immediately after l ocal finger cooling was increased by enalapril compared to baseline. The T- channel-inhibiting calcium antagonist mibefradil did not change CBV in fing er nailfold capillaries. (C) 1999 Academic Press.