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Fosinopril reduces left ventricular mass in untreated hypertensive patients: a controlled trial
1Department of Medicine, University of Hong Kong, Hong Kong.
Insights
Fosinopril significantly reduced left ventricular mass in hypertensive patients over 12 weeks. This angiotensin-converting enzyme inhibitor offers a potential new treatment for cardiovascular risk reduction.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Left ventricular hypertrophy (LVH) is a significant predictor of cardiovascular events.
- Hypertension is a primary driver of LVH.
Purpose of the Study:
- To investigate the effect of fosinopril, an angiotensin-converting enzyme inhibitor, on left ventricular mass in hypertensive patients.
- To test the hypothesis that fosinopril reduces LVH.
Main Methods:
- A randomized, placebo-controlled trial involving 33 patients with untreated mild essential hypertension.
- Patients received either oral fosinopril (10-20 mg daily) or placebo for 12 weeks.
- Left ventricular mass index (LVMI) was measured using echocardiography.
Main Results:
- Fosinopril significantly reduced both systolic and diastolic blood pressure compared to placebo.
- Fosinopril treatment led to a significant reduction in left ventricular mass index (LVMI) by 14.9 g/m² (95% CI 2.2-27.6).
- No significant changes were observed in left ventricular systolic or diastolic function, plasma electrolytes, or renal function.
Conclusions:
- Fosinopril effectively reduces left ventricular mass in hypertensive patients.
- This suggests fosinopril may be a valuable therapeutic option for managing hypertensive heart disease and reducing cardiovascular risk.
Aims:
Left ventricular hypertrophy is a powerful predictor of cardiovascular morbidity and mortality. We tested the hypothesis that fosinopril, an angiotensin-converting enzyme inhibitor, reduces left ventricular mass in hypertensive patients.
Methods:
Thirty-three patients with untreated mild essential hypertension were randomised to treatment with oral fosinopril (10 mg-20 mg daily) or placebo for 12 weeks. The primary outcome measure was the change in left ventricular mass index determined by echocardiography.
Results:
Diastolic blood pressure changed from 95.5+/-2.1 mmHg at baseline to 96.6+/-2.8 mmHg at the final visit in control patients and changed from 96.6+/-2.3 mmHg to 91.5+/-3.0 mmHg in patients treated with fosinopril (P= 0.04). Systolic blood pressure changed from 147.4+/-3.2 mmHg at baseline to 152.7+/-4.4 mmHg at the final visit in control patients and changed from 157.6+/-5.1 mmHg to 149.1+/-6.1 mmHg in patients treated with fosinopril (P=0.02). Fosinopril reduced diastolic pressure by 6.3 (95%CI 0.3-12.4) mmHg and systolic pressure by 13.3 (95%CI 2.7-23.8) mmHg compared with placebo. The left ventricular mass index changed from 110.0+/-8.3 gm(-2) to 113.1+/-8.7 g m(-2) in the control patients and changed from 120.8+/-5.8 g m(-2) to 109.0+/-7.5 g m(-2) in patients treated with fosinopril (P=0.02). Fosinopril reduced left ventricular mass index by 14.9 (95%CI 2.2-27.6) g m(-2) compared with placebo. There was no significant change in the left ventricular systolic or diastolic function, nor were there any significant changes in plasma electrolytes and renal function.
Conclusions:
Treatment with fosinopril for 12 weeks reduced left ventricular mass significantly in hypertensive patients.