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Perindopril and indapamide reverse coronary microvascular remodelling and improve flow in arterial hypertension

Danilo Neglia1, Enza Fommei, Anabel Varela-Carver

  • 1Fondazione G Monasterio CNR-Regione Toscana, Pisa, Italy.

Journal of Hypertension
|November 4, 2010
PubMed

Insights

Antihypertensive treatment with perindopril + indapamide improved myocardial blood flow in patients with arterial hypertension. This study in patients and rats showed that the medication reverses coronary microvascular remodelling and enhances blood flow.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Biology

Background:

  • Arterial hypertension is linked to coronary microcirculation abnormalities.
  • Left ventricular hypertrophy (LVH) is a common complication of hypertension.
  • Understanding microvascular changes is crucial for effective hypertension management.

Purpose of the Study:

  • To investigate if antihypertensive treatment can reverse coronary microvascular remodelling in hypertensive patients and animal models.
  • To assess the impact of treatment on myocardial perfusion.

Main Methods:

  • A translational study involving 20 hypertensive patients with LVH and spontaneously hypertensive rats.
  • Patients received perindopril + indapamide for 6 months; rats received placebo or the same treatment for 8 weeks.
  • Measurements included blood pressure, left ventricular mass index, myocardial blood flow, coronary flow, and arteriolar histomorphometry.

Main Results:

  • Perindopril + indapamide significantly reduced blood pressure and LVH in patients, while increasing myocardial blood flow.
  • In rats, the treatment lowered blood pressure and significantly improved hyperaemic coronary flow.
  • Histomorphometry revealed reverse remodelling of intramural coronary arterioles in treated rats.

Conclusions:

  • Perindopril + indapamide effectively reduces blood pressure and LVH in hypertensive patients.
  • The treatment improves both resting and hyperaemic myocardial blood flow.
  • Evidence suggests that improved coronary flow is due to reverse remodelling of the coronary microcirculation.
Abstract

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