Effects of perindopril on cardiovascular remodeling

The primary aim in the medical treatment of hypertension is to lower blood pressure (BP). A wide variety of agents have proved effective for meeting t his goal. However, an ideal agent for management of hypertensive patients m ust also meet a number of additional criteria. It should have a significant positive impact on conditions that are likely to be associated with elevat ed BP and that are known risk factors for cardiovascular morbidity and mort ality. This article reviews effects of the long-acting angiotensin-converti ng enzyme inhibitor perindopril erbumine on hypertension-associated blood v essel and myocardial remodeling known to be associated with increased cardi ovascular risk. Long-term treatment with perindopril improves arterial comp liance and increases the media-lumen ratio of peripheral resistance vessels . These effects appear to be at least partially independent of BP lowering. Reversal of hypertension-associated vascular remodeling with perindopril s hould decrease afterload and reduce or reverse left ventricular hypertrophy . Evaluation of patients who have received long-term perindopril therapy ha s shown this to be the case. This effect of perindopril on an important pre dictor of cardiovascular morbidity and mortality may also be partially inde pendent of BP. The combination of treatment with such agents as perindopril and methods that permit early detection of vascular changes contributing t o cardiovascular disease has the potential to markedly improve the prognosi s for hypertensive patients and others at risk for development of cardiovas cular disease. (C) 2001 by Excerpta Medica, Inc.