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      Remodeling of Resistance Arteries in Human Hypertension: Effects of Cilazapril, an Angiotensin- I -Converting Enzyme Inhibitor

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          Abstract

          Studies on the effect of antihypertensive agents on resistance arteries in hypertensive patients have in the past yielded inconclusive results regarding the ability of these drugs to induce a regression toward normal of either the structure or the function of these critically important vessels. We have recently compared the effects of the angiotensin-I-converting enzyme inhibitor cilazapril and of the beta blocker atenolol on the structure and the function of subcutaneous resistance arteries of essential hypertensive patients. The patients were randomly assigned to receive either cilazapril or atenolol for a period of 2 years. The blood pressure was normalized for the duration of the trial by both drugs. The media-to-lumen ratio of resistance arteries, which was significantly increased in all hypertensive patients before starting treatment, was normalized by the 2-year treatment with cilazapril, whereas treatment with atenolol did not result in any change in this vascular parameter. Treatment with cilazapril also returned to normal the contractile responses to several vasoconstrictors, particularly endothelin 1. Endothelium-dependent relaxation responses of blood vessels to acetylcholine were abnormal in hypertensive patients and improved in the cilazapril-treated patients, but remained unchanged in the atenolol-treated ones. We conclude that treatment with the angiotensin-I-converting enzyme inhibitor cilazapril corrects in part the vascular remodeling and the functional abnormalities of resistance arteries of hypertensive patients, whereas treatment with the beta blocker atenolol does not. These results may indicate that treatment with cilazapril and perhaps with other angiotensin-I-converting enzyme inhibitors as well may improve the clinical outcome in hypertension by inducing a regression of abnormal resistance vessel structure and function.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-6154-9
          978-3-318-01937-7
          0008-6312
          1421-9751
          1995
          1995
          19 November 2008
          : 86
          : Suppl 1
          : 16-22
          Affiliations
          MRC Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montreal, University of Montreal, Canada
          Article
          176941 Cardiology 1995;86:16–22
          10.1159/000176941
          7614501
          bf6413a4-9df6-4209-a978-c3ec71e64468
          © 1995 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          Page count
          Pages: 7
          Categories
          Paper

          General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
          Angiotensin-I-converting enzyme inhibitors,Vascular remodeling,Vascular hypertrophy,Essential hypertension,Beta blockers,Blood vessels

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