Rizzoni D, Muiesan ML, Porteri E, Castellano M, et al.
Regression of structural alterations in small subcutaneous
resistance arteries after long-term antihypertensive treatment
with lisinopril in hypertensive patients with LVH
11th Scientific Meeting, American Society of Hypertension
Am J Hypert
(Apr) 9:24a 1996
Ten hypertensives were studied before and after 3 years of therapy
with lisinopril. Measurements of left ventricular mass index were
obtained by echocardiography and an index of vascular hypertrophy,
media/lumen ratio, assessed by micromyography in small resistance
arteries obtained from gluteal subcutaneous fat biopsies. Compared to
pretreatment measurements, lisinopril-treated patients showed
regression of left ventricular and vascular hypertrophy. Left
ventricular mass index and media/lumen ratio remained significantly
greater in treated hypertensives than in age- and sex-matched
normotensives.
Comment: Parallelism between factors contributing to
ventricular and vascular hypertrophy has long been assumed, but data
are scarce. This study, while to be interpreted with caution because
of the small number of patients and the lack of a parallel control
group, supports the notion that blood pressure lowering can reverse
hypertrophy throughout the cardiovascular system. Since structural
factors are thought to reinforce and amplify other
hypertension-promoting processes, regression of vascular change is
probably beneficial. Whether more aggressive blood pressure lowering
will completely reverse hypertensive vascular structural adaptations
remains to be seen. Likewise, it is not known whether differing drug
actions will result in different effects at the vascular level.
(Alan Weder, M.D., University of Michigan)
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11th Scientific Meeting, American Society of Hypertension
H: Drug therapy :
ACE inhibitors
H: Pathophysiology :
Microvascular pathology