Comparative Efficiency of Enalapril and Perindopril in Terms of the Effect on Central Blood Pressure and Elastic Properties of Arteries in Patients with Mild to Moderate Hypertension
Introduction. Central aortic pressure is a strict criterion of target organ damage and cardiovascular mortality compared with the pressure in the brachial artery.
Objective: to compare the effectiveness of enalapril and perindopril in reducing central aortic pressure and improving elastic properties of arteries in patients with mild to moderate hypertension.
Materials and methods. We conducted surveillance involving 40 patients with mild to moderate hypertension (20 men, 20 women). All patients were divided into 2 groups of perindopril 4–8 mg/day
(n = 20) and enalapril 20–40 mg/day (n = 20) therapy. The procedure of examination at baseline and in 6 months included the measurement of office systolic (SBP) and diastolic blood pressure (DBP), ambulatory blood pressure monitoring (ABPM), evaluation of central blood pressure, pulse wave velocity (PWV) and blood lipids.
Results. After 6 months of therapy, there was a significant reduction in office systolic and diastolic blood pressure in both groups: by 30.60/17.30 mm — in the enalapril group, and by 30.60/16.10 mm — in the perindopril group. BP during daily monitoring decreased effectively and equally in both treatment groups, and SBP/DBP reduction in the enalapril group was 16.78/12.19 mmHg, and in the perindopril group — 18.64/10.11 mmHg.
The level of the central SBP significantly decreased in both groups: in the enalapril group — by 16.40 ± 3.07 mmHg, and in the perindopril group — by 16.15 ± 4.59 mmHg. In the enalapril group, augmentation index decreased by 4.9 %, and in the perindopril group — by 2.6 %. Both groups showed improvement of elastic properties of arteries by reducing PWV in elastic arteries. In the enalapril group, PWV decreased by 0.96 m/s, in the perindopril group — by 1.4 m/s (p > 0.05 between groups, probably due to the small number of cases).
Conclusion. Central systolic blood pressure in both groups reduced significantly equally, with the same lowering of office BP and BP in ABPM. PWV decreased in both groups, but in the group perindopril, this decline was greater in comparison with the enalapril group.
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