| Comparative effects of enalapril and verapamil on myocardial blood flow in systemic hypertension. | |
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MedLine Citation:
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PMID: 9264494 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The comparative effects of calcium channel blockers and ACE inhibitors on myocardial blood flow (MBF) in hypertensive patients after long-term treatment are still unknown. METHODS AND RESULTS: Twenty hypertensive subjects with normal coronary arteries were randomly assigned to verapamil 240 to 480 mg/d or enalapril 10 to 40 mg/d. MBF was quantified at rest, during pacing tachycardia, and after dipyridamole by positron emission tomography and 13N-ammonia before and 6 months after treatment after 1 week of pharmacological washout. In both groups, blood pressure and heart rate during flow measurements were not different before and after therapy. Before treatment, mean MBF at rest, during pacing tachycardia, and after dipyridamole infusion was similar in the two groups; however, pacing and dipyridamole flows were significantly lower than those obtained in a control group of normotensive subjects. After treatment, in the enalapril-treated patients, MBF did not change in the three study conditions. In the verapamil-treated patients, MBF did not change at rest and significantly increased during pacing and after dipyridamole. The inhomogeneity of regional MBF distribution, evaluated from the coefficient of variation, decreased at rest after both treatments and, in the enalapril group, also during pacing. No relation was found between changes in MBF and changes in left ventricular mass. CONCLUSIONS: In arterial hypertension, MBF during pacing tachycardia and after dipyridamole is impaired. Successful therapy with verapamil increases MBF response to these stimuli, independent of changes in perfusion pressure and left ventricular mass. These results suggest that verapamil directly improves coronary microcirculatory function in hypertension. Enalapril does not significantly change MBF but reduces the inhomogeneity of regional flow distribution. |
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Authors:
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O Parodi; D Neglia; C Palombo; G Sambuceti; A Giorgetti; C Marabotti; M Gallopin; I Simonetti; A L'Abbate |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 96 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1997 Aug |
Date Detail:
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Created Date: 1997-09-15 Completed Date: 1997-09-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 864-73 Citation Subset: AIM; IM |
Affiliation:
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Institute of Clinical Physiology of the National Council of Research, Pisa, Italy. parodi@po.ifc.pi.cnr.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antihypertensive Agents
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therapeutic use* Calcium Channel Blockers / therapeutic use Cardiac Pacing, Artificial Coronary Circulation / drug effects* Dipyridamole / diagnostic use Enalapril / therapeutic use* Female Humans Hypertension / drug therapy*, physiopathology*, radionuclide imaging Male Middle Aged Reproducibility of Results Single-Blind Method Tomography, Emission-Computed Vasodilator Agents / diagnostic use Verapamil / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Vasodilator Agents; 52-53-9/Verapamil; 58-32-2/Dipyridamole; 75847-73-3/Enalapril |
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