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[Effects of enalapril on left ventricular hypertrophy in patients with mild or moderate essential hypertension]
M Batlouni1, D Armaganijan, J E Assef
1Instituto Dante Pazzanese de Cardiologia, São Paulo.
Purpose:
To evaluate the effects of enalapril maleate on the regression of left ventricular hypertrophy (LVH) associated to hypertension.
Patients And Methods:
Fifteen male, age between 45 and 65 years (mean age = 56 y) with diagnosis of mild-to-moderate essential hypertension (greater than diastolic blood pressure [DBP] less than between 90 and 114 mmHg) and LHV at the echocardiogram. The administration of enalapril maleate was initiated with a 20 mg daily dosage and titrated up to a maximum of 40 mg daily, whenever DBP was maintained above 90 mmHg and no adverse experience occurred.
Results:
Fourteen patients completed the clinical trial and all of them achieved satisfactory blood pressure (BP) control. The dosage of enalapril was 20 mg/day for 11 patients and 40 mg/day for the other three. The mean systolic blood pressure in supine position decreased from an initial value of 151.4 +/- 9.5 to 126.4 +/- 9.4 mmHg at the end of treatment and the mean diastolic blood pressure from 100.0 +/- 5.0 to 80.4 +/- 1.5 mmHg (p less than 0.001). There was a reduction of mean diastolic septal wall thickness from 11.5 +/- 0.05 to 10.1 +/- 0.05 mm and left ventricular posterior wall thickness from 11.2 +/- 0.7 to 9.8 +/- 0.6 mm (p less than 0.05). The diastolic dimension and left ventricular volume did not show significant changes. The mean of calculated left ventricular mass showed a decrease from 263.6 +/- 32.9 to 231.3 +/- 34.7 g at the end of treatment (p less than 0.05). Mean ejection fraction and fractional fiber shortening showed light, but non significant increase. The tolerability to the drug was satisfactory. Two patients complained of transient palpitations and two other, irritative cough, that determined the treatment discontinuation in one case.
Conclusion:
Enalapril maleate 20 to 40 mg daily, besides the satisfactory control of BP in patients with mild-to-moderate essential hypertension, promoted regression of left ventricular hypertrophy, without impairment of left ventricular function.