| Presence of cardiovascular structural changes in essential hypertensive patients with coronary microvascular disease and effects of long-term treatment. | |
| | |
MedLine Citation:
|
PMID: 8722438 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
In asymptomatic essential hypertensive patients with angiographically normal coronary arteries and without left ventricular hypertrophy, dipyridamole-induced ischemic-like ST segment depression may be a marker of coronary microvascular disease. In this study we evaluated, first, whether this cardiac abnormality is linked to structural or functional vascular abnormalities, and second, the effect of antihypertensive treatment by 12-month administration of the angiotensin converting enzyme (ACE) inhibitor captopril (50 mg twice a day orally). In essential hypertensives with dipypridamole echocardiography stress test (DET) (DET+, n = 8) and without (DET-, n = 8) ST segment depression greater than 0.1 mV during intravenous dipyridamole infusion (0.84 mg/kg over 10 min), we studied the forearm blood flow (FBF, venous plethysmography, mL/100) modifications induced by intrabrachial acetylcholine (Ach) (0.15, 0.45, 1.5, 4.5, 15 micrograms/100 mL/min x 5 min each), an endothelium-dependent vasodilator, and by sodium nitroprusside (SNP) (1, 2, 4 micrograms/100 mL/min x 5 min each), a smooth muscle cell relaxant compound. Minimal forearm vascular resistances (MFVR), an index of arteriolar structural changes, were also calculated. Both Ach and SNP caused greater vasodilation in DET- as compared to DET+ while MFVRs were lower in DET- compared to DET+. After treatment, both DET+ and DET- patients showed a significant and similar reduction in blood pressure and left ventricular mass index, while vasodilation to acetylcholine and sodium nitroprusside was increased only in the DET+ group. In addition, forearm minimal vascular resistances were significantly reduced only in DET+ patients, who showed disappearance of dipyridamole-induced ischemic-like ST segment depression. In conclusion, these data confirm that essential hypertensive patients with microvascular coronary disease are characterized by the presence of structural changes in the forearm vascular bed. Our results also indicate that both cardiac and forearm vascular abnormalities can be reversed by antihypertensive treatment with an ACE inhibitor. |
| | |
Authors:
|
A Virdis; L Ghiadoni; A Lucarini; V Di Legge; S Taddei; A Salvetti |
Related Documents
:
|
10422218 - An inhibitor of angiotensin converting enzyme (enalapril) augments endotoxin-induced hy... 6188888 - Antihypertensive effects of captopril in combination with diuretics in spontaneously hy... 7035038 - Effect of captopril on blood pressure and bradykinin vasodepressor responses after neph... 18090068 - Aliskiren: an oral renin inhibitor for the treatment of hypertension. 21272628 - Optimization of microdermabrasion for controlled removal of stratum corneum. 9052298 - Venous bleeding during transsphenoidal surgery: its association with pre- and intraoper... |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
|
Title: American journal of hypertension Volume: 9 ISSN: 0895-7061 ISO Abbreviation: Am. J. Hypertens. Publication Date: 1996 Apr |
Date Detail:
|
Created Date: 1996-09-26 Completed Date: 1996-09-26 Revised Date: 2009-02-24 |
Medline Journal Info:
|
Nlm Unique ID: 8803676 Medline TA: Am J Hypertens Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 361-9 Citation Subset: IM |
Affiliation:
|
I Clinica Medica, University of Pisa, Italy. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acetylcholine
/
pharmacology Adult Angiotensin-Converting Enzyme Inhibitors / therapeutic use* Captopril / therapeutic use* Coronary Circulation / drug effects* Dipyridamole / diagnostic use Echocardiography Electrocardiography Female Forearm / blood supply Humans Hypertension / drug therapy*, ultrasonography Hypertrophy, Left Ventricular / drug therapy Male Microvascular Angina / drug therapy, ultrasonography Middle Aged Vascular Resistance / drug effects |
| Chemical | |
Reg. No./Substance:
|
0/Angiotensin-Converting Enzyme Inhibitors; 51-84-3/Acetylcholine; 58-32-2/Dipyridamole; 62571-86-2/Captopril |
| Comments/Corrections | |
Comment In:
|
Am J Hypertens. 1996 Apr;9(4 Pt 1):406-8
[PMID:
8722445
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Rationale and design for the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack T...
Next Document: Defective endothelium-dependent relaxation in fructose-hypertensive rats.