Comparative effect of cilnidipine and quinapril on left ventricular mass in mild essential hypertension

The aim of this study was to compare the regressive effect of cilnidipine on left ventricular mass (LVM) with that of quinapril. Sixty patients with mild essential hypertension aged more than 39 years were randomly allocated to two groups to receive cilnidipine (10 mg; n = 30) or quinapril (10 mg; n = 30). The patients underwent echocardiography before and 12 months after drug treatment. Sixteen patients in each group underwent I-123-metaiodobenzylguanidine (MIBG) cardiac imaging before and 12 months after drug treatment In both groups systolic and diastolic blood pressures significantly decreased to similar levels. In the cilnidipine group, both end-diastolic and end-systolic diameters and posterior wall thickness significantly decreased, while only end-systolic diameter significantly decreased in the quinapril group, However LVM (206 36 g to 189 +/- 40 g, p < 0.02 for the quinapril group, 195 +/- 60 g to 171 +/- 48 g, p < 0.004 for the cilnidipine group) and the LVM index (127 +/- 20 g/m(2) to 116 +/- 20 g/m(2), p < 0.02 for the quinapril group, 121 +/- 32 g/m(2) to 106 +/- 24 g/m(2), p < 0.003 for the cilnidipine group) significantly decreased in both groups. Regarding MIBG imaging, in the cilnidipine group, the heart-to-mediastinum ratio significantly increased (p < 0.02) and the washout rate significantly decreased (p < 0.02) after drug treatment. In contrast, there were no significant changes in MIBG parameters in the quinapril group. Cilnidipine produced a greater decrease in LVM in essential hypertension than quinapril, probably due to the long-term suppression of the cardiac sympathetic nervous system. Cilnidipine is useful for hypertensive patients with left ventricular hypertrophy and may improve their prognosis.