LEFT-VENTRICULAR MASS REGRESSION AND DIASTOLIC FUNCTION IMPROVEMENT IN MILD AND MODERATE HYPERTENSIVE PATIENTS TREATED WITH LISINOPRIL

Thirty patients (18 male), mean age 49.5 +/- 6.3 years, were treated with lisinopril 10-40 mg once daily for 16 weeks. The effect of treatment on left ventricular mass and improvement in left ventricular diastolic function (measured by echo-Doppler) was assessed. Blood pressure changes were measured conventionally in the clinic and by ambulatory blood pressure monitoring. Clinic blood pressure decreased from 168.3 +/- 13.8/105.5 +/- 5.4 mm Hg to 137.5 +/- 4.1/88.8 +/- 4.1 mm Hg (p < 0.005 for both systolic and diastolic blood pressures), and the heart rate from 75.2 +/- 3.7 to 74.4 +/- 7.6 beats per minute (NS). The frequency of ambulatory systolic blood pressure values > 140 mm Hg decreased in percentage from 6 3.3 +/- 12.8 to 29.9 +/- 9.1% (p < 0.005) and the frequency of ambulatory diastolic blood pressure values >90 mm Hg decreased in percentage from 61.1 +/- 12.8 to 28.6 +/- 7.5% (p < 0.005). Septal and left ventricular posterior wall thickness decreased from 11.2 +/- 0.9 to 10.3 +/- 0.6 mm and from 10.9 +/- 0.9 to 10.1 +/- 0.6 mm, respectively (both p < 0.005). Left ventricular diastolic diameter and the shortening fraction did not change significantly. Left ventricular mass, calculated from left ventricular wall thickness and diastolic diameter, decreased from 132.6 +/- 11.5 to 119.9 +/- 6.3 g/m2 (p < 0.005). Peak Doppler E-wave velocity increased from 59.2 +/- 10.4 to 67.7 +/- 8.3 cm/s (p < 0.005) and the peak A-wave velocity decreased from 60.3 +/- 6.3 to 52.6 +/- 6.2 cm/s (p < 0.005). The E/A peak ratio increased from 0.98 +/- 1.4 to 1.3 +/- 0.21 (p < 0.005). These results demonstrate that lisinopril is effective in reducing blood pressure and left ventricular mass and also improving diastolic function without affecting left ventricular systolic function.