TY - JOUR
T1 - Cardiac and hormonal effects of enalapril in hypertension
AU - Morioka, Shigefumi
AU - Simon, Geza
AU - Cohn, Jay N.
PY - 1983/11
Y1 - 1983/11
N2 - Systolic time measurements, echocardiography, and bicycle exercise testing with cardiac output determinations (CO2 rebreathing) were used to evaluate cardiac performance in 16 male hypertensives at the end of a 4-wk placebo period and after 12 wk of treatment with increasing doses (maximum = 40 mg/day) of enalapril maleate (N = 11) and of placebo (N = 5). The effect of exercise on plasma renin activity (PRA) and plasma norepinephrine (NE) concentration was also measured. Mean arterial pressure was reduced by 10 mm Hg or more in all but one subject who received enalapril. In both the enalapril- and placebo-treated subjects, the preejection period/left ventricular ejection time ratio and fractional shortening of the left ventricle at rest and cardiac output and stroke volume during moderate exercise did not change during the study. Enalapril induced a compensatory rise in PRA (N = 10). Compared to plasma NE concentration, 1124 ± 380 pg/ml (mean ± SD), during exercise at the end of the initial placebo period, there was attenuation of the rise of plasma NE concentration, 851 ± 290, at the same load of exercise during enalapril therapy. Unchanged cardiac performance despite effective long-term lowering of blood pressure with enalapril may relate to inhibition of angiotensin 11-mediated facilitation of NE release from peripheral nerve endings.
AB - Systolic time measurements, echocardiography, and bicycle exercise testing with cardiac output determinations (CO2 rebreathing) were used to evaluate cardiac performance in 16 male hypertensives at the end of a 4-wk placebo period and after 12 wk of treatment with increasing doses (maximum = 40 mg/day) of enalapril maleate (N = 11) and of placebo (N = 5). The effect of exercise on plasma renin activity (PRA) and plasma norepinephrine (NE) concentration was also measured. Mean arterial pressure was reduced by 10 mm Hg or more in all but one subject who received enalapril. In both the enalapril- and placebo-treated subjects, the preejection period/left ventricular ejection time ratio and fractional shortening of the left ventricle at rest and cardiac output and stroke volume during moderate exercise did not change during the study. Enalapril induced a compensatory rise in PRA (N = 10). Compared to plasma NE concentration, 1124 ± 380 pg/ml (mean ± SD), during exercise at the end of the initial placebo period, there was attenuation of the rise of plasma NE concentration, 851 ± 290, at the same load of exercise during enalapril therapy. Unchanged cardiac performance despite effective long-term lowering of blood pressure with enalapril may relate to inhibition of angiotensin 11-mediated facilitation of NE release from peripheral nerve endings.
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U2 - 10.1038/clpt.1983.219
DO - 10.1038/clpt.1983.219
M3 - Article
C2 - 6313274
AN - SCOPUS:0021044044
SN - 0009-9236
VL - 34
SP - 583
EP - 589
JO - Clinical pharmacology and therapeutics
JF - Clinical pharmacology and therapeutics
IS - 5
ER -