The effect of enalapril and telmisartan on clinical and biochemical indices of sympathetic activity in hypertensive patients.
OBJECTIVE
To compare the effect of ARB and ACE inhibitor on sympathetic activity in 32 hypertensives.


METHODS
After a four-week wash-out period, patients were randomized to four weeks of therapy with enalapril or telmisrtan, with crossover to another drug for another four weeks. Blood pressure (BP), NPY, and catecholamine levels and HRV (frequency analysis) were measured during wash-out, in basal condition, and after postural stimulation test (PST).


RESULTS
Both drugs significantly reduced BP and NPY as compared to initial values, while no differences in BP and NPY between drugs were observed. Increase in NPY during PST was significantly higher in the enalapril than in the telmisartan group and during the wash-out period. No differences between enalapril and telmisartan in plasma catecholamines were observed. Telmisartan decreased low frequency/high frequency ratio as compared to initial values and enalapril values.


CONCLUSIONS
Despite similar BP control, telmisartan attenuated autonomic balance more effectively than enalapril.
Lewandowski
Jacek
J
Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Poland.
Abramczyk
Piotr
P
Dobosiewicz
Anna
A
Bidiuk
Joanna
J
Sinski
Maciej
M
Gaciong
Zbigniew
Z
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D001562:Benzimidazoles / Q000494:pharmacology* / Q000627:therapeutic use; D001565:Benzoates / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D018592:Cross-Over Studies; D004656:Enalapril / Q000494:pharmacology* / Q000627:therapeutic use; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009478:Neuropeptide Y / Q000097:blood / Q000187:drug effects; D009638:Norepinephrine / Q000097:blood; D011187:Posture / Q000502:physiology; D013564:Sympathetic Nervous System / Q000187:drug effects*; D000077333:Telmisartan; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001565:Benzoates; D009478:Neuropeptide Y; D004656:Enalapril; D000077333:Telmisartan; D009638:Norepinephrine; D004837:Epinephrine