Enalapril does not improve left ventricular diastolic dysfunction in young and mild hypertensives without concomitant hypertrophy

The aim of the study was to determine whether enalapril monotherapy can improve left ventricular diastolic dysfunction (LVDD) in young and mild hypertensive patients without concomitant left ventricular hypertrophy (LVH). Fifty patients with hypertension less than or equal to 160/100 mm Hg, aged less than or equal to 50 years, normal two-dimensional echocardiographic (2-D echo) measurements, and LVDD were enrolled in this study. The LVDD was defined as a transmitral early (E) to atrial(A) peak velocity ratio of 1. The mean documented hypertension was 6.3 years. The mean daily dose of enalapril was 13 mg. Baseline and 24-month follow-up echocardiograms were evaluated. Thirty-eight age- and sex-matched healthy subjects served to establish the normal reference values of 2-D echo measurements. After treatment, peak early diastolic velocity (E) (49 +/- 6 cm/sec v 48 +/- 10 cm/sec; P = not significant), peak atrial velocity (A) (62 +/- 9 cm/sec v 62 +/- 10 cm/sec; P = not significant), and E/A ratio (0.80 +/- 0.10 v 0.78 +/- 0.13; P = not significant) remained unchanged. Moreover, early to atrial velocity-time integral ratio (1.24 +/- 0.08 v 1.23 +/- 0.11; P = not significant) did not change. The left ventricular mass index, relative wall thickness, left ventricular end-systolic diameter, left atrial diameter, fractional shortening, heart rate, and body mass index did not show significant changes in all hypertensive patients. In conclusion, longterm antihypertensive therapy with enalapril did not lead to an improvement of LVDD in young and mild hypertension patients without concomitant LVH.