MILD-TO-MODERATE ESSENTIAL-HYPERTENSION TREATED WITH TRANDOLAPRIL - IMPROVEMENTS IN CIRCULATION AND MICROCIRCULATION

The effects of trandolapril on the circulation and microcirculation of 17 patients with mild to moderate essential hypertension without targ et-organ damage were evaluated. The study had two phases: a 4-week, si ngle-blind, placebo run-in period followed by 3 months of open-label t reatment with trandolapril 2 mg once daily, given orally. Treatment ef fects were studied with B-mode evaluation of femoral artery diameter a nd with laser Doppler flowmetry (LDF). Normal systolic and diastolic b lood pressure readings were attained in 60% of patients; 66% were cons idered responders. Heart rate was not changed. Skin resting flow, as m easured by LDF, was increased from an average of 0.87 to 2.9 flow unit s (P<.01). Skin flow on local heating increased by a mean of 2.95 unit s; skin flow on standing remained unchanged. The venoarteriolar respon se (VAR, the vasoconstrictor response on standing) increased from a ba seline median of 57.14 to 91.3 at month 3 (P<.01). On average, femoral artery diameter increased by 0.5 mm (P<.01). Trandolapril was an effe ctive and well-tolerated antihypertensive agent. The improvements in c irculation, as seen in the increased femoral artery diameter, and in m icrocirculation, as evidenced by increased skin flow and VAR, occurred with the 2-mg once-daily dosage.