EFFECTS OF PERINDOPRIL ON LEFT-VENTRICULAR MASS AND ON DIASTOLIC FUNCTION IN MILD-TO-MODERATE HYPERTENSION

This study was designed to analyse the relationship between arterial blood pressure and diostolic function in essential hypertension. Fifteen patients with mild-to-moderate hypertension and both left ventricular hypertrophy and trans-mitral flow alterations underwent on echo-doppler examination and 24-hour ambulatory blood pressure monitoring at the end of a placebo run-in period and after six months of treatment with an ACE inhibitor, perindopril, 4-8mg daily. Perindopril induced a significant reduction in blood pressure in all patients with no change in heart rate. Left ventricular moss was significantly reduced, but there were no significant variations in cardiac output or contractility indexes. Diastolic function was not improved by the therapy and abnormalities of left ventricular filling were almost unchanged. These findings suggest that mechanisms, other than blood pressure, influence left diastolic filling in hypertension. Left ventricular mass reduction should be attributed to the haemodynamic effects of perindopril.