The use of enalapril in hypertensive patients with metabolic disturbances

Twenty four hour blood pressure monitoring, echocardiography, ECC, registra tion of coagulogram and psychological testing were used for assessment of e fficacy and tolerance of the angiotensin-converting enzyme inhibitor enalap ril (5-40 mg/day for 3 months, average dose 18,1+/-10,3 mg/day) in 35 patie nts with mild to moderate hypertension and metabolic disturbances. Enalapri l affected favorably types of 24-hour blood pressure (BP) curves. Lowering of systolic and diastolic BP was observed both at night time (by 16,4%, p<0 ,01, and 17,6%, p<0,01, respectively) and during waking period (by 15,7%, p <0,001, and 11,4%, p<0,001, respectively). In patients with high BP variabi lity there occurred lowering of standard deviation of systolic and diastoli c BP during day time (by 30%, p<0,001, and 34%, p<0,001, respectively), and at night (by 31%, p<0,01, and 33%, p<0,01, respectively). Significant atte nuation of amplitude and rate of morning BP rise was also observed. Therapy with enalapril did not cause aggravation of preexisting metabolic disturba nces. In 53% of patients echocardiography revealed normalization of paramet ers of left ventricular diastolic relaxation and filling. By the end of 3 m onths of therapy the index of quality of lire improved by 18% (p<0,05). Ena lapril was well tolerated. The data obtained demonstrated high efficacy and good tolerance of enalapril in the treatment of mild and moderate hyperten sion with metabolic disturbances.