Effects of Angiotensin-Converting Enzyme Inhibitor on Arterial Stiffness, Diastolic Function, and Exercise Performance in Patients with Hypertension

ABSTRACT

BACKGROUND: The aim of this study was to investigate the relations between arterial stiffness, diastolic function, and exercise performance and the effects of angiotensin-converting enzyme inhibitor(ACEI), perindopril, in these three areas in patients with hypertension(HT). METHODS: A total of 39 patients(60.9+/-4.9 years, 23 males) with a newly diagnosed or untreated HT, stage I, were enrolled. Arterial stiffness measured by pulse wave velocity, diastolic function measured by echocardiography, and exercise performance and hemodynamic parameters measured by a treadmill exercise test were compared before and after 6 months of medical treatment with an ACEI. RESULTS: The parameters for arterial stiffness, diastolic function, and exercise performance did not show significant correlations with each other at baseline. Systolic(from 147.6+/-6.5mmHg to 134.3+/-9.6mmHg, p<0.001) and diastolic blood pressures(from 87.7+/-7.5mmHg to 82.9+/-6.2mmHg, p<0.001) decreased significantly after 6 months of ACEI treatment. Except for duration of total exercise time, the parameters for arterial stiffness, diastolic function, and the hemodynamic response to exercise also improved significantly after 6 months of ACEI treatment. CONCLUSION: Though the parameters for arterial stiffness, diastolic function, and exercise performance were not asso- ciated with each other at baseline, they all improved significantly after 6 months of medical treatment with an ACEI in elderly patients with stage I HT. The results of this study suggest the possibility of additional benefits of ACEI beyond lowering blood pressure.