It is generally accepted that the development of left ventricular hypertrophy (LVH) represents a multifactorial phenomenon that also involves neurohormonal mechanisms. This finding may account for the ability of angiotensin-converting enzyme inhibitors to induce faster and more complete reversal of LVH than that observed with other antihypertensive treatments. The sympathetic system is also involved in the genesis of hypertension- induced LVH. We assessed the effects of satisfactory long-term treatment with rilmenidine, a new oxazoline with a potent antihypertensive action, on cardiovascular structural abnormalities and cardiac endocrine function in hypertensive patients with left ventricular hypertrophy. Eleven patients underwent M-mode and two-dimensional Doppler echocardiography, peripheral pulsed Doppler flowmetry, determination of plasma atrial natriuretic factor [(ANF) pg/ml] and renin activity, and 24-h urine electrolyte excretion under control conditions, after 4 weeks of blood pressure normalization, after 1 year of satisfactory antihypertensive treatment and, finally, 4 weeks after therapy withdrawal. LVH (g/m2 body surface area) was reversed after 1-year treatment (from 152 ± 5 to 131 ± p <0.05). One-year treatment induced an improvement in brachial artery compliance (cm4/dyne · 107) (from 0.92 ± 0.06 to 1.16 ± 0.08, p <0.05) that persisted after withdrawal of treatment (1.17 ± 0.06, p <0.05). Plasma renin activity and urinary electrolyte excretion did not change throughout the study, whereas ANF remained unchanged after blood pressure normalization (48.4 ± 6.2 versus 44.7 ± 2.9, NS), fell after reversal of LVH (28.6 ± 3.4, p <0.05), and remained significantly lower than under control conditions after therapy withdrawal (27.5 ± 2.9, p <0.05). These results demonstrate that a satisfactory long-term antihypertensive treatment with rilmenidine is able to reverse cardiovascular structural changes and to restore cardiac endocrine function.
|Journal||Journal of Cardiovascular Pharmacology|
|Issue number||SUPPL. 2|
|Publication status||Published - 1995|
- Antihypertensive treatment
- Atrial natriuretic factor
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine