[The therapy of complicated forms of essential hypertension with the ACE inhibitor perindopril].
The paper presents a comparison of the influence of angiotensin-converting enzyme (ACE) with high (perindopril) or low (enalapril) affinity to the endothelial renin-angiotensin-aldosterone system on the dynamics of the content of humoral endothelial dysfunction markers in patients with essential hypertension (EH) complicated by ischemic cerebral stroke. The subjects of the study were patients with EH complicated by acute cerebral ischemia, who received hospital treatment with perindopril (52 patients) or enalapril (58 patients). Changes in the physical properties of the cytoplasmatic membrane and phosphatidylserine exterialization were studied in peripheral blood on lymphocyte model. In peripheral blood plasma, the dynamics of sPECAM-1 titre and antiphospholipid antibodies (APLA) were studied. All the patients had high contents of blebbing and Annexin-positive lymphocytes, as well as high sPECAM-1 and APLA titres on the 1st day of hospital treatment. These variables decreased by the 20th day of hospital stay. In patients receiving perindopril the contents of endothelial dysfunction markers under study decreased more prominantly vs. patients in the other group. The elevation of endothelial dysfunction markers is a result of its progression and oxidative stress effect. Endothelial dysfunction can be corrected, which is proved by the decrease in the level of its markers by the 20th day of hospital treatment. The most prominent therapeutic effect of perindopril is a result of its high affinity to endothelial ACE and the inhibition of bradykinin degradation.
Inzhutova
A I
AI
Petrova
M M
MM
Salmina
A B
AB
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000453:epidemiology* / Q000503:physiopathology*; D015897:Comorbidity; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D020913:Perindopril