Effect of enalapril maleate on vascular endothelial function and platelet-endothelial interactions in patients with essential hypertension

Aim. Evaluation of endothelial function and platelet-endothelial interactio ns in patients with essential hypertension and dynamics of these changes in the course of treatment with enalapril maleate. Materials and methods. The study included 37 patients with essential hypert ension and 22 normotensive volonteers. 17 of hypertensive patients received enalapril maleate (enap, KRKA) 5-20 mg/day during the period of 1.5 months . The complex of investigations included: measurement of total plasma chole sterol, 12-lead ECG, echocardiography, high-resolution ultrasound investiga tion of brachio-cephalic arteries, evaluation of flow mediated dilatation, measurement of von Willebrand's factor, spontaneous and induced platelet ag gregation. Results. Patients with essential hypertension exhibited higher levels of vo n Willebrand's factor in plasma and degree of spontaneous and induced plate let aggregation as well as lower responses of vessel wall to hemodynamic st imuli compared to normotensive healthy individuals. There,vas a strong corr elation between endothelial function markers and CAD risk factors, elevatio n of platelet activity. Treatment with enalapril maleate led to a statistic ally significant decrease of von Willebrand's factor in plasma and ex vivo platelet aggregation whereas flow-mediated dilatation increased. Values of endothelial function markers and platelet activity approached to those of n ormotensive subjects and these changes were accompanied by a decrease of EC C signs of left ventricular hypertrophy. Conclusion. Patients with essential hypertension were found to have comprom ised endothelial function. However, the degree of endothelial dysfunction d epends not on hemodynamic parameters, but on the cumulative effect of CAD r isk factors. Treatment with enalapril maleate may lead to normalisation of endothelial function and decrease of platelet activity.