DIFFERENTIAL RESPONSE IN LEFT-VENTRICULAR MASS AND ARTERIAL RESISTIVEINDEX FOLLOWING FOSINOPRIL THERAPY

The aim of this study was to assess the differential response in left ventricular mass and resistive index (RI) of renal and carotid arterie s in mild to moderate essential hypertensive patients after 1 year of ACE inhibitor therapy. Twenty-six patients (mean age 42.9 +/- 10.9 yea rs) underwent 24-hour ambulatory blood pressure monitoring, echocardio graphy and renal and carotid echo-Doppler (by measuring RI, as an expr ession of arterial impedance) after a placebo period and 12 months of fosinopril treatment (20 mg/day). Our study showed a significant decre ase in 24-hour BP (p < 0.05), left cardiac mass (p < 0.05) and RI of c ommon carotid and hilum renal arteries (p < 0.05). In contrast, there were no significant reductions in the interlobar renal RI (as an expre ssion of unchanged intrarenal resistance) and in the internal carotid artery RI. While the 24-hour BP decrease was strongly correlated with the left cardiac mass modifications (r = 0.73, p < 0.005), no signific ant relationship was observed with the renal and carotid artery parame ters. In conclusion, the present study demonstrated that long-term tre atment with fosinopril produced a differential response in left ventri cular mass and arterial RI in patients with mild to moderate essential hypertension. In addition, the arterial impedance modifications of co mmon carotid and hilum renal artery were largely unrelated to the 2-ho ur BP reduction.