[Long-term effects of captopril treatment on the course of stable effort angina pectoris and structural-functional characteristics of platelets in patients with hypertension and ischemic heart disease].
OBJECTIVE
To assess clinical efficacy and effect on platelet alterations of 12-month captopril monotherapy in essential hypertension (EH) patients with coronary heart disease (CHD).


METHODS
A randomized placebo-controlled parallel study was performed. Arterial blood pressure (BP), frequency of angina pain attacks, standard submaximal bicycle exercise test (BET), echocardiography, ADP-induced platelet aggregation (PA), levels of cholesterol (CH), lipid peroxidation products, intracellular Ca, Ca(++)-ATPase activity were studied before and 2 weeks, 2, 6 and 12 months after captopril therapy in 68 males aged 35-58 years with moderate EH in combination with CHD, stable angina of effort and normal left ventricular ejection fraction (57.5 +/- 1.2%).


RESULTS
In spite of a stable antihypertensive effect of C within all the treatment period, frequency of anginal pain attacks and number of positive BET markedly reduced only during 6 months of C therapy. Left ventricular hypertrophy regression was not registered. Of all the platelet parameters only Ca(++)-ATPase, Ca and malonic dialdehyde (MDA) beneficial changes persisted for 12 month treatment period: Ca(++)-ATPase activity increased, Ca and MDA content reduced. The other platelet parameters were less persistent. BP lowering correlated with Ca(++)-ATPase, CH, MDA and PA changes whereas the number of anginal pain attack correlated with CH and PA reduction.


CONCLUSIONS
A beneficial effect of captopril on BP persisted for 12 months, on angina symptoms--for 6 months. One of the mechanisms of antihypertensive and antianginal effect of captopril is attributed to platelet alterations correction.
Shafer
M Zh
MZh
Gul'tiaeva
E P
EP
Gapon
L I
LI
Alfimova
T V
TV
D000328:Adult; D000787:Angina Pectoris / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects*; D002216:Captopril / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D010919:Placebos; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D010919:Placebos; D002216:Captopril
Vliianie dlitel'nogo lecheniia kaptoprilom na techenie stabil'noĭ stenokardii napriazheniia i strukturno-funktsional'noe sostoianie trombotsitov u bol'nykh s sochetaniem gipertonicheskoĭ bolezni i ishemicheskoĭ bolezni serdtsa.