Cardiac effects of trandolapril in hypertension.
Baseline echocardiography was performed on 25 patients with essential hypertension and a supine diastolic blood pressure of 95 to 114 mm Hg while receiving placebo. Once-daily trandolapril was then titrated from 1 to 4 mg. After 3 months of therapy, supine diastolic blood pressure decreased by 7.5% (p < 0.0001). Left ventricular hypertrophy regressed as evidenced by a 23.2% (p < 0.0001) decrease in left ventricular mass index at 3 months and a 12.4% (p < 0.05) reduction of relative wall thickness at 6 months. Although afterload decreased by 12.4% (p < 0.05) at 3 months, left ventricular systolic function remained unchanged, whereas left ventricular contractility, which was assessed from the load-independent relationship of end-systolic wall stress to velocity of circumferential fiber shortening, improved. Left ventricular diastolic function (E/A ratio) improved in 15 of 25 patients with low baseline values from 0.96 +/- 0.14 to 1.18 +/- 0.25 (mean +/- SD, p < 0.0002) at 3 months. We conclude that trandolapril effectively reduces left ventricular hypertrophy and improves diastolic function in patients with hypertension while systolic function is preserved.
Guller
B
B
Echocardiographic Laboratory, Blood Pressure Research Clinic, Olympia, Wash.
Hall
J
J
Reeves
R L
RL
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000188:drug therapy; D007211:Indoles / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D000806:Angiotensin-Converting Enzyme Inhibitors; D007211:Indoles; C052035:trandolapril