This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kiowski, W. Articles by Martina, B. Search for Related Content PubMed PubMed Citation Articles by Kiowski, W. Articles by Martina, B.

(Hypertension. 1996;27:371-376.)
© 1996 American Heart Association, Inc.

Articles

Effects of Cilazapril on Vascular Structure and Function in Essential Hypertension

Wolfgang Kiowski; Lilly Linder; Reto Nuesch; Benedikt Martina

From the Division of Cardiology (W.K., L.L.) and Medical Policlinic (R.N., B.M.), Department of Medicine, University Hospital; Basel, Switzerland.

Correspondence to Prof W. Kiowski, MD, Division of Cardiology, Department of Medicine, University Hospital, CH 8091 Zürich, Switzerland.

Abstract Hypertension is associated with an altered design of resistance vessels and decreased endothelium-dependent vasodilator response to acetylcholine. A role of angiotensin II in both defects is suggested by animal experiments in which angiotensin-converting enzyme inhibition reverted structural and functional changes. We investigated the effects of 20 weeks of therapy with the angiotensin-converting enzyme inhibitor cilazapril (5 mg twice daily) on the endothelium-dependent response to brachial artery infusions of acetylcholine and the endothelium-independent vascular relaxation after sodium nitroprusside in 22 subjects with mild to moderate essential hypertension. In addition, we measured minimal forearm vascular resistance (ratio of mean arterial pressure and forearm blood flow after heating, ischemia, and ischemic exercise) as an indirect estimate of vascular structure. Cilazapril decreased blood pressure (151±14/99±7 mm Hg during placebo to 138±17/89±8 mm Hg after cilazapril treatment, P<.01) and baseline (42.2±12.6 to 37.1±10.6 U, P<.05) and minimal (3.0±1.1 to 2.4±0.7 U, 15.9±20.2%; P<.05) forearm vascular resistances. The change in minimal forearm vascular resistance was unrelated to age, duration of hypertension, or changes in blood pressure. Sodium nitroprusside increased forearm blood flow from 2.6±1.0 to 11.4±5.9 mL/min per 100 mL and acetylcholine to 21.5±17.8. Both responses did not change after cilazapril. The data provide indirect evidence that cilazapril therapy may improve vascular structure in human hypertension. The lack of relationship between vascular and blood pressure changes would be compatible with experimental evidence supporting a role for angiotensin II in the development and regression of vascular changes, but this needs further study. Therapy with cilazapril for 20 weeks, like other antihypertensive therapy, does not seem to influence endothelial vasodilator function in humans to a significant degree.

Key Words: acetylcholine • angiotensin-converting enzyme inhibitors • blood vessels • hypertension, essential • vascular resistance • vasodilation • endothelium

This article has been cited by other articles:

				M. Kosch, A. Levers, D. Lang, V. Bartels, K. H. Rahn, H. Pavenstadt, and M. Hausberg A randomized, double-blind study of valsartan versus metoprolol on arterial distensibility and endothelial function in essential hypertension Nephrol. Dial. Transplant., July 1, 2008; 23(7): 2280 - 2285. [Abstract] [Full Text] [PDF]

				L. Ghiadoni, A. Magagna, D. Versari, I. Kardasz, Y. Huang, S. Taddei, and A. Salvetti Different Effect of Antihypertensive Drugs on Conduit Artery Endothelial Function Hypertension, June 1, 2003; 41(6): 1281 - 1286. [Abstract] [Full Text] [PDF]

				S. Taddei, A. Virdis, L. Ghiadoni, D. Versari, G. Salvetti, A. Magagna, and A. Salvetti Calcium Antagonist Treatment by Lercanidipine Prevents Hyperpolarization in Essential Hypertension Hypertension, April 1, 2003; 41(4): 950 - 955. [Abstract] [Full Text] [PDF]

				G. S. Stokes, E. S. Barin, and K. L. Gilfillan Effects of Isosorbide Mononitrate and AII Inhibition on Pulse Wave Reflection in Hypertension Hypertension, February 1, 2003; 41(2): 297 - 301. [Abstract] [Full Text] [PDF]

				G. Zalba, G. S. Jose, M. U. Moreno, M. A. Fortuno, A. Fortuno, F. J. Beaumont, and J. Diez Oxidative Stress in Arterial Hypertension: Role of NAD(P)H Oxidase Hypertension, December 1, 2001; 38(6): 1395 - 1399. [Abstract] [Full Text] [PDF]

				R. Corti, J. C. Burnett Jr, J. L. Rouleau, F. Ruschitzka, and T. F. Luscher Vasopeptidase Inhibitors: A New Therapeutic Concept in Cardiovascular Disease? Circulation, October 9, 2001; 104(15): 1856 - 1862. [Abstract] [Full Text] [PDF]

				S. Taddei, A. Virdis, L. Ghiadoni, A. Magagna, S. Favilla, A. Pompella, and A. Salvetti Restoration of Nitric Oxide Availability After Calcium Antagonist Treatment in Essential Hypertension Hypertension, March 1, 2001; 37(3): 943 - 948. [Abstract] [Full Text] [PDF]

				L. Ghiadoni, A. Virdis, A. Magagna, S. Taddei, and A. Salvetti Effect of the Angiotensin II Type 1 Receptor Blocker Candesartan on Endothelial Function in Patients With Essential Hypertension Hypertension, January 1, 2000; 35(1): 501 - 506. [Abstract] [Full Text] [PDF]

				F. Perticone, R. Ceravolo, R. Maio, G. Ventura, S. Iacopino, G. Cuda, P. Mastroroberto, M. Chello, and P. L. Mattioli Calcium antagonist isradipine improves abnormal endothelium-dependent vasodilation in never treated hypertensive patients Cardiovasc Res, January 1, 1999; 41(1): 299 - 306. [Abstract] [Full Text] [PDF]

				L.-T. Dijkhorst-Oei, J. J. Beutler, E. S.G. Stroes, H. A. Koomans, and T. J. Rabelink Divergent effects of ACE-inhibition and calcium channel blockade on NO-activity in systemic and renal circulation in essential hypertension Cardiovasc Res, November 1, 1998; 40(2): 402 - 409. [Abstract] [Full Text] [PDF]

				U. Onaka, K. Fujii, I. Abe, and M. Fujishima Antihypertensive Treatment Improves Endothelium-Dependent Hyperpolarization in the Mesenteric Artery of Spontaneously Hypertensive Rats Circulation, July 14, 1998; 98(2): 175 - 182. [Abstract] [Full Text] [PDF]

				C. Cardillo and J. A Panza Impaired endothelial regulation of vascular tone in patients with systemic arterial hypertension Vascular Medicine, May 1, 1998; 3(2): 138 - 144. [Abstract] [PDF]

				H. Iwatsubo, M. Nagano, T. Sakai, K. Kumamoto, R. Morita, J. Higaki, T. Ogihara, and T. Hata Converting Enzyme Inhibitor Improves Forearm Reactive Hyperemia in Essential Hypertension Hypertension, January 1, 1997; 29(1): 286 - 290. [Abstract] [Full Text] [PDF]