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Hvidovre Hospital - a part of Copenhagen University Hospital
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ACE inhibition with spirapril improves diastolic function at rest independent of vasodilation during treatment with spirapril in mild to moderate hypertension

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  • J R Petersen
  • H Drabaek
  • Christian Peter-Ole G. Gleerup
  • J Mehlsen
  • L J Petersen
  • K Winther
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The effects of the ACE inhibitor spirapril and of hydrochlorothiazide on left ventricular diastolic function were studied. Thirteen patients with mild to moderate essential hypertension completed this randomized, double-blinded, placebo-controlled, crossover study. After a three-week run-in period the patients entered three periods lasting four weeks each, wherein they were treated with placebo, spirapril, or hydrochlorothiazide. Blood pressure, hemodynamic variables (stroke volume, heart rate, cardiac output, index of contractility, and systemic vascular resistance), echocardiography (left ventricular mass), and Doppler-derived atrial to early (A/E)-ratio velocity time integrals (VTI) were measured at the end of each of the four periods. Spirapril lowered the A/E-ratio VTIs (0.57, 0.12-1.00) (P <0.02) as compared with both placebo (0.80, 0.50-2.67) and hydrochlorothiazide (0.83, 0.44-1.25), and the drug normalized the A/E-ratio VTI in those patients with elevated values. The hemodynamic variables, left ventricular mass, and end-systolic wall stress were unchanged during all three treatments. There were no significant changes in mean blood pressure during the treatment periods. These results indicate that spirapril lowers A/E ratio within four weeks in patients with mild to moderate essential hypertension. It thereby seems able to improve left ventricular diastolic function. The effect is not dependent upon changes in hemodynamic variables, blood pressure, left ventricular mass, or end-systolic wall stress.
Original languageEnglish
JournalAngiology
Volume47
Issue number3
Pages (from-to)233-40
Number of pages8
ISSN0003-3197
Publication statusPublished - 1996

    Research areas

  • Aged, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Blood Flow Velocity, Blood Pressure, Cardiac Output, Cardiography, Impedance, Cross-Over Studies, Diastole, Double-Blind Method, Echocardiography, Enalapril, Female, Heart Rate, Humans, Hydrochlorothiazide, Hypertension, Male, Middle Aged, Myocardial Contraction, Rest, Stroke Volume, Vascular Resistance, Vasodilation, Ventricular Function, Left

ID: 35972059