ABSTRACT
OBJECTIVE: To determine whether long-term treatment with cilazapril (CIL) may improve pulse pressure (PP), arterial compliance and ankle-arm systolic index (AAI) in patients with lower-extremity arterial disease (LEAD). Indeed, in both systolic hypertension and LEAD, the increase in pulse pressure has been attributed to a reduced compliance. DESIGN AND METHODS: Thirteen patients (age: 65 +/- 5 yrs; AAI: 0.78 +/- 0.15; m +/- SD) were included in a double-blind randomized parallel study to compare the effects of a 6 month treatment with CIL (10 mg per day; n = 6) to those of placebo (PL; n = 7) Blood pressure, AAI and arterial compliance were determined at baseline (MO) and after 3 (M3) and 6 months (M6). Common carotid (CC) and common femoral (CF) artery compliances were noninvasively determined from pulsatile changes in arterial diameter (Wall Track System, Hoeks et al., 1990) and pressure (PP). RESULTS: Both groups were comparable at MO. Compared to PL, CIL significantly reduced PP (-22 +/- 4 vs -2 +/- 9 mmHg) and MAP (-16 +/- 11 vs -4 +/- 7 mmHg) and improved CC (+54 +/- 34 vs +5 +/- 21 mm2.mmHg-1.10(-3)) at M6. Weaker effects were observed at M3. No significant changes in AAI and CF compliance were observed. CONCLUSIONS: A direct effect of CIL on the large artery wall was suggested by 1) a greater reduction in PP than in MAP and 2) a disproportionately greater improvement in CC compliance compared with the reduction in distending pressure (MAP). These results indicate that long-term treatment with CIL may improve large artery function in patients with LEAD.
