Comparative Effects of Enalapril and Verapamil on Myocardial Blood Flow in Systemic Hypertension

Abstract

In arterial hypertension, MBF during pacing tachycardia and after dipyridamole is impaired. Successful therapy with verapamil increases MBF response to these stimuli, independent of changes in perfusion pressure and left ventricular mass. These results suggest that verapamil directly improves coronary microcirculatory function in hypertension. Enalapril does not significantly change MBF but reduces the inhomogeneity of regional flow distribution.

Relations of left ventricular mass and systolic function to endothelial function and coronary flow reserve in healthy, new discovered hypertensive subjects

“…Others found weak and clinically not relevant relationship between LV mass index and CFR. 15,17 Motz et al 46 first reported coronary endothelial dysfunction in hypertensive undergoing coronary angiography for angina pectoris. In our study, FMD findings did not impact on the lack of relation between LV mass index and CFR.…”

“…With this regard, early experimental and clinical invasive studies reported association of LVH with reduced CFR. [6][7][8][9][10] However, others failed to find significant independent relationship between CFR and LVH, [11][12][13][14][15][16][17] and the independent relation between LVH and abnormal CFR remains disputed. In addition, LVH is independently associated with coronary artery disease, 18 which may confound the relation between LVH and CFR.…”

Angiotensin converting enzyme inhibitors for cancer treatment?

“…2,4,[17][18][19][20] Two of these used the PET technique, 2,4 whereas 4 studies used the argon gas chromatography technique. [17][18][19][20] However, using the latter invasive procedure only allows investigation of hypertensive patients with symptoms of ischemia, whereas the PET technique permits investigations of asymptomatic patients, who constitute the majority of the hypertensive population.…”

“…[1][2][3][4] This abnormality could result in reduced exercise capacity and myocardial ischemia in situations with high oxygen demands, 1,5 but the background for this microcirculatory disturbance is not clear. The presence of left ventricular hypertrophy may contribute, 6,7 but structural remodeling of myocardial resistance arteries also seems important.…”

“…11,14,16 The effect of antihypertensive treatment on myocardial perfusion (MP) has been investigated in a number of studies. 2,4,[17][18][19][20] ACE inhibitors 4,19,20 have, with some exceptions, 2 demonstrated reductions in myocardial vascular resistance, which is ascribed to structural repair of coronary arterioles. 20 On this basis it might be expected that the reduced coronary reserve seen in hypertension would be improved by treatment with an ACE inhibitor, but not by a ␤-blocker.…”