Regression of structural alterations in small subcutaneous resistance arteries after long-term antihypertensive treatment with lisinopril in hypertensive patients with left ventricular hypertrophy.

To evaluate the effect of a prolonged and effective antihypertensive therapy with the ACE-inhibitor lisinopril on structural alterations of small resistance arteries in hypertensive patients with left ventricular hypertrophy. Methods: Ten patients with left ventricular hypertrophy [Left ventricular mass index (LVMi) at entry 144±13, blood pressure (BP) ± ] were treated for an average of 3 years with lisinopril 20 mg per day (LIS). In those patients in whom a satisfactory control of clinic blood pressure was not achieved during monotherapy, hydrochlorothiazide 12.5 mg was added (n=4). Patients underwent an echocardiographic evaluation of LVMI every 12 months. At the end of the treatment period, small resistance arteries were obtained by biopsy of the subcutaneous fat in the gluteal region, small arteries were dissected and mounted on a micromyograph (Mulvany and Halpern technique); the media-lumen ratio was then calculated. Data obtained were compared with those observed in 10 untreated essential hypertensive patients (UEH) matched for age, sex, blood pressure and left ventricular mass index and in 10 age- and sex-matched normotensive subjects (NT). Results: were as follows: (*=p<0.05, ***=p<0.001 vs. NT, #=p<0.05 vs. UEH; O=p<0.05 vs. baseline) Conclusion: a long-term therapy with lisinopril was able to reduce significantly structural alterations in the small resistance arteries in patients with left ventricular hypertrophy.