Skip to main content
SpringerLink
Log in

Differential Response in Left Ventricular Mass and Arterial Resistive Index following Fosinopril Therapy

  • Clinical Pharmacodynamic
  • Published:
Clinical Drug Investigation Aims and scope Submit manuscript

Summary

The aim of this study was to assess the differential response in left ventricular mass and resistive index (RI) of renal and carotid arteries in mild to moderate essential hypertensive patients after 1 year of ACE inhibitor therapy. Twenty-six patients (mean age 42.9 ± 10.9 years) underwent 24-hour ambulatory blood pressure monitoring, echocardiography and renal and carotid echo-Doppler (by measuring RI, as an expression of arterial impedance) after a placebo period and 12 months of fosinopril treatment (20 mg/day). Our study showed a significant decrease in 24-hour BP (p < 0.05), left cardiac mass (p < 0.05) and RI of common carotid and hilum renal arteries (p < 0.05). In contrast, there were no significant reductions in the interlobar renal RI (as an expression of unchanged intrarenal resistance) and in the internal carotid artery RI. While the 24-hour BP decrease was strongly correlated with the left cardiac mass modifications (r = 0.73, p < 0.005), no significant relationship was observed with the renal and carotid artery parameters. In conclusion, the present study demonstrated that long-term treatment with fosinopril produced a differential response in left ventricular mass and arterial RI in patients with mild to moderate essential hypertension In addition, the arterial impedance modifications of common carotid and hilum renal artery were largely unrelated to the 24-hour BP reduction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Folkow B. Physiological aspects of primary hypertension. Physiol Rev 1982; 62: 347–504

    PubMed  CAS  Google Scholar 

  2. Frohlich ED, Apstein C, Chobonian AV, et al. The heart in hypertension. N Engl J Med 1992; 327(14): 998–1008

    Article  PubMed  CAS  Google Scholar 

  3. Laufer R, Jennings GL, Korner PI, et al. Prevalence of cardiac structural and functional abnormalities in untreated primary hypertension. Hypertension 1989; 13: 151–62

    Article  PubMed  CAS  Google Scholar 

  4. Devereux RB, Pickering TG, Alderman MH, et al. Left ventricular hypertrophy in hypertension. Hypertension 1987; 9(2): 53–60

    Google Scholar 

  5. Cifkova R, Niederle P, Romanovska L, et al. Heart and vessel hypertrophy in hypertension: possibilities and regression. J Hypertens 1987; 5 Suppl. S407–S411

    CAS  Google Scholar 

  6. Abi-Samra F, Fouad FM, Tarazi RC. Determinants of left ventricular hypertrophy and function in hypertensive patients: an echocardiographic study. Am J Med 1982; 75Suppl. 3A: 26–31

    Google Scholar 

  7. Sihm I, Schroeder AP, Aalkjaer C, et al. The relation between peripheral vascular structure left ventricular hypertrophy, and ambulatory blood pressure in essential hypertension. Am J Hypertens 1995; 8: 987–96

    Article  PubMed  CAS  Google Scholar 

  8. MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke and coronary heart disease. Pt I: effects of prolonged differences in blood pressure. Evidence from nine prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335: 765–74

    Article  PubMed  CAS  Google Scholar 

  9. Shigematsu Y, Hamada M, Mukai M, et al. Clinical evidence for an association between left ventricular geometric adaptation and extracardiac target organ damage in essential hypertension. J Hypertens 1995; 13: 155–60

    Article  PubMed  CAS  Google Scholar 

  10. Collins R, Peto R, MacMahon S, et al. Blood pressure, stroke and coronary heart disease. Pt II: effects of short-term reductions in blood pressure. An overview of the unconfounded randomised drug trials in an epidemiological context. Lancet 1990; 335: 827–38

    Article  PubMed  CAS  Google Scholar 

  11. MacMahon S, Rodgers A. The effects of antihypertensive treatment on vascular disease: reappraisal of the evidence in 1994. J Vasc Med Biol 1993; 4: 265–71

    Google Scholar 

  12. Handa N, Fukunaga R, Uehara A, et al. Echo-Doppler veloci-meter in the diagnosis of hypertensive patients: the renal artery Doppler technique. Ultrasound Med Biol 1986; 12: 945–52

    Article  PubMed  CAS  Google Scholar 

  13. Hollenberg NK, Mongel R, Fung HYM. Assessment of intrarenal perfusion with radioxenon: a critical review of analytical factors and their implications in man. Semin Nucl Med 1976; 6: 99–105

    Google Scholar 

  14. Veglio F, Provera E, Pinna G, et al. Renal resistive index after captopril test by echo-Doppler in essential hypertension. Am J Hypertens 1992; 5: 431–6

    PubMed  CAS  Google Scholar 

  15. Rittgers SE, Norris CS, Barnes RW. Detection of renal artery stenosis: experimental and clinical analysis of velocity waveforms. Ultrasound Med Biol 1985; 11: 523–31

    Article  PubMed  CAS  Google Scholar 

  16. Reid MH, MacKay RS, Lantz MT. Noninvasive blood flow measurements by Doppler ultrasound with applications to renal artery flow determination. Invest Radiol 1980; 15: 323–31

    Article  PubMed  CAS  Google Scholar 

  17. Rittenhouse EA, Maitner W, Burr JW, et al. Directional arterial flow velocity: a sensitive index of changes in peripheral resistances. Surgery 1976; 79: 350–5

    PubMed  CAS  Google Scholar 

  18. Agabiti Rosei E, Ambrosioni E, Dal Palu'C, et al. ACE inhibitor ramipril is more effective than the beta-blocker atenolol in reducing left ventricular mass in hypertension. Results of the RACE (ramipril cardioprotective evaluation) study. J Hypertens 1995; 13: 1325-34

    Google Scholar 

  19. Asmar RG, Journo HT, Lacolley PJ, et al. Treatment for one year with perindopril: effect on cardiac mass and arterial compliance in essential hypertension. J Hypertens 1988; 6Suppl. 3: S33–S39

    CAS  Google Scholar 

  20. The Fifth Report of The Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med 1993; 153: 154-83

    Google Scholar 

  21. Veglio F, Rabbia F, Melchio R, et al. Statistical evaluation of circadian blood pressure rhythm during isradipine long-term therapy. Eur J Clin Pharmacol 1994; 46: 119–22

    Article  PubMed  CAS  Google Scholar 

  22. Sahn DJ, DeMaria A, Kisslo J, et al. Results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–83

    Article  PubMed  CAS  Google Scholar 

  23. Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986; 57: 450–8

    Article  PubMed  CAS  Google Scholar 

  24. Savage DD, Garrison RJ, Kannel WB, et al. The spectrum of left ventricular hypertrophy in a general population sample: the Framingham study. Circulation 1987; 75Suppl. I: I–26–I–33

    Google Scholar 

  25. Veglio F, Frascisco M, Melchio R, et al. Assessment of renal resistance index after captopril test by Doppler in essential and renovascular hypertension. Kidney Int 1995; 48: 1611–6

    Article  PubMed  CAS  Google Scholar 

  26. Rorive GL, Carlier PG, Foidart JM. The structural responses of the vascular wall in experimental hypertension: In: Zanchetti A, Tarazi RC, editors. Handbook of Hypertension. Vol 7. Pathophysiology of Hypertension. Elsevier Science Publishers BV1986: 427-53

  27. Tarazi RC. The role of the heart in hypertension. Clin Sci 1982; 63 Suppl.: 347S–358S

    Google Scholar 

  28. Asmar RG, Pannier B, Santoni JPG, et al. Reversion of cardiac hypertrophy and reduced arterial compliance after converting enzyme inhibition in essential hypertension. Circulation 1988; 78: 941–950

    Article  PubMed  CAS  Google Scholar 

  29. Blake J, Devereux RB, Herrold EM, et al. Relation of concentric left ventricular hypertrophy and extracardiac target organ damage to supranormal left ventricular performance in established essential hypertension. Am J Cardiol 1988; 62: 246–252

    Article  PubMed  CAS  Google Scholar 

  30. Ganau A, Devereux RB, Roman MJ, et al. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol 1992; 19: 1550–8

    Article  PubMed  CAS  Google Scholar 

  31. Devereux RB, James GD, Pickering TG. What is normal blood pressure? Comparison of ambulatory pressure level and variability in patients with normal or abnormal left ventricular geometry. Am J Hypertens 1993; 6 Suppl.: 211S–215S

    PubMed  CAS  Google Scholar 

  32. Dahlof B, Pennert K, Hansson L. Reversal of left ventricular hypertrophy in hypertensive patients. A metaanalysis of 109 treatment studies. Am J Hypertens 1992; 5: 95–110

    PubMed  CAS  Google Scholar 

  33. Cooper G, Kent RL, Mann DL. Load induction of cardiac hypertrophy. J Mol Cell Cardiol 1989; 21Suppl. V: 11–30

    Article  PubMed  Google Scholar 

  34. Norris CS, Barnes RW. Renal artery flow velocity analysis: a sensitive measure of experimental and clinical renovascular resistance. J Surg Res 1984; 36: 230–6

    Article  PubMed  CAS  Google Scholar 

  35. Grant EG, Wong W, Tessler F, et al. Cerebrovascular ultrasound imaging. Radiol Clin North Am 1988; 26: 1111–8

    PubMed  CAS  Google Scholar 

  36. Winsberg F, Beretsky I. High frequency imaging with simultaneous Doppler investigation. Echorevue 1986; 3: 2–9

    Google Scholar 

  37. Kett MM, Alcorn D, Bertram JF, et al. Enalapril does not prevent renal arterial hypertrophy in spontaneously hypertensive rats. Hypertension 1995; 25: 335–42

    Article  PubMed  CAS  Google Scholar 

  38. Sihm I, Schroeder AP, Aalkjaer C, et al. Normalization of structural cardiovascular changes during antihypertensive treatment with a regimen based on the ACE-inhibitor perindopril. Blood Press 1995; 4(4): 241–8

    Article  PubMed  CAS  Google Scholar 

  39. Boutouyrie P, Laurent S, Girerd X, et al. Common carotid artery stiffness and patterns of left ventricular hypertrophy in hypertensive patients. Hypertension 1995; 25 Pt 1: 651–9

    Article  PubMed  CAS  Google Scholar 

  40. Safar ME, Peronneau PP, Levenson JA, et al. Pulsed Doppler: diameter, velocity and flow of the brachial artery in sustained essential hypertension. Circulation 1981; 63: 393–400

    Article  PubMed  CAS  Google Scholar 

  41. Simon A, Levenson JA, Bouthier JD, et al. Evidence of early degenerative changes in large arteries in human essential hypertension. Hypertension 1985; 7: 675–80

    Article  PubMed  CAS  Google Scholar 

  42. Isnard RN, Pannier BM, Laurent S, et al. Pulsatile diameter and elastic modulus of the aortic arch in essential hypertension: a non invasive study. J Am Coll Cardiol 1989; 13: 399–405

    Article  PubMed  CAS  Google Scholar 

  43. Armentano R, Simon A, Levenson J, et al. Mechanical pressure versus intrinsic effects of hypertension on large arteries in humans. Hypertension 1991; 18: 657–64

    Article  PubMed  CAS  Google Scholar 

  44. Arcaro G, Laurent S, Jondeau G, et al. Stiffness of the common carotid artery in hypertensive patients. J Hypertens 1991; 9: 947–54

    Article  PubMed  CAS  Google Scholar 

  45. Bots ML, Hofman A, de Bruyn AM, et al. Isolated systolic hypertension and vessel wall thickness of the carotid artery: the Rotterdam Elderly Study. Arterioscler Thromb 1993; 13: 64–9

    Article  PubMed  CAS  Google Scholar 

  46. Reneman RS, van Merode T, Hick P, et al. Flow velocity patterns in and distensibility of the carotid artery bulb in subjects of various ages. Circulation 1993; 87: 705–19

    Article  Google Scholar 

  47. Benetos A, Asmar R, Gautier S, et al. Heterogeneity of the arterial tree in essential hypertension: a noninvasive study of the terminal aorta and the common carotid artery. J Human Hypertens 1994; 8: 501–7

    CAS  Google Scholar 

  48. Mayet J, Shahi M, Poulter NR, et al. Left ventricular diastolic function in hypertension: a 4 year follow-up study. Int J Cardiol 1995; 50(2): 181–8

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine and Experimental Oncology, University of Turin, Turin, Italy

    Franco Veglio, L. Coda, R. Melchio, F. Rabbia & L. Chiandussi

  2. Department of Internal Medicine, University of Turin, Turin, Italy

    L. Gastaldi

  3. Vascular Diagnostic Unit, G. Bosco Hospital, Turin, Italy

    M. Frascisco

Authors
  1. Franco Veglio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Gastaldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Frascisco
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Coda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. Melchio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Rabbia
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. Chiandussi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Veglio, F., Gastaldi, L., Frascisco, M. et al. Differential Response in Left Ventricular Mass and Arterial Resistive Index following Fosinopril Therapy. Clin. Drug Investig. 15, 101–109 (1998). https://doi.org/10.2165/00044011-199815020-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00044011-199815020-00004

Keywords

Search

Navigation