ABSTRACT
BACKGROUND: Perindopril. a new second-generation angiotensin converting enzyme inhibitor developed by Servier Research, was administered in essential hypertensive patients in order to observe the clinical effects. METHOD: The changes of blood pressure, heart rate, quality of life, clinical laboratory examinations, side effects, electrocardiogram and echocardiographic left ventricular mass were evaluated before and after 4-12mg of perindopril 12 weeks' administration in 25 essential hypertensive patients(mild 10, moderate 8, severe 5, very severe 2 : male 7, female 18 ; mean age 53.1+/-8.9 years). RESULT: 1) After treatment with perindopril alone, blood pressures were lowered markedly in 17(68%), moderately in 5(20%) and mildly in 2(8%) cases. The average of blood pressures of 25 subjects were systolic 173.1+/-22.8mmHg and diastolic 105.9+/-9.5mmHg before treatment, which were lowered to 125.2+/-14.9mmHg and 83.2+/-9.0mmHg respectively after 12 weeks(p<0.0001). 2) Quality of Life improved markedly in 11(44%) and slightly in 9(36%) cases after perindopril administration. 3) On electrocardiographic follow-up study, three out of five left ventricular hypertrophy with strain, seven out of 13 left ventricular hypertrophy, two out of three ST segment and T wave change and two sinus tachycardia were improved. Echocardiographic left ventricular mass was reduced significantly form 249.4+/-72.7g to 202.9 56.3g after 12 weeks perindopril treatment(p<0.0001). 4) Side effects were 5 cases of dry cough and 3 facial flushing. 5) Final Assessment of perindopril effect including hypotensive effect, quality of life, left ventricular mass regression and side effect showed very useful in 16(64%) and useful in 6(24%) out of 25 subjects. CONCLUSION: Perindopril may be an effective initial single antihypertensive agent for the treatment of varying degree of hypertension, especially with left ventricular hypertrophy.