Ramipril effects on cerebral blood flow and microcirculation in patients with essential arterial hypertension
Abstract
Aim. To assess ramipril effects on microcirculation (MC) and cerebral blood flow (CBF) in patients with Stage II-III arterial hypertension (AH).
Material and methods. In total, 37 patients with Stage II-III AH were examined. Thirty patients completed the study, receiving ramipril (2,5-20 mg/d) and hydrochlorothiazide (12,5 mg/d) for 6 months. At baseline, after one and six months, clinical examination, Doppler ultrasound of extracranial vessels, and MC assessment by conjunctival biomicroscopy were performed.
Results. By the end of the study, target blood pressure level was achieved in 86% of the participants. Main parameters of MC and CBF correlated with each other. Ramipril therapy was associated with normalization of CBF and MC, primary due to the beneficial effects on capillary and intravascular MC.
Conclusion. Inter-correlation between MC and CBF parameters support the interrelation between pathological processes in patients with AH and target organ damage, and also facilitate the assessment of ramipril protective effects on CBF. Long-term ramipril and hypothiazide therapy improved both MC and CBF in patients with Stage II-III AH.
About the Authors
L. I. Markova
Moscow State Medico-Stomatological University, Moscow
Russian Federation
Russian Federation
A. E. Radzevich
Moscow State Medico-Stomatological University, Moscow
Russian Federation
Russian Federation
I. V. Samsonova
Vidnoye Central District Hospital, Moscow Region, Vidnoye
Russian Federation
Russian Federation
E. V. Vasilyeva
Moscow State Medico-Stomatological University, Moscow
Russian Federation
Russian Federation
References
1. Ю. Н. Беленков, В. Ю. Мареев, Ф. Т. Агеев Ингибиторы ангиотензин-превращающего фермента в лечении сердечно-сосудистых заболеваний. Москва 2001; 32–43.
2. В. И. Бувальцев, Ф. Е. Горбачева, Г. М. Натяжкина и др. Состояние мозгового кровотока у больных с тяжелым поражением сосудов головного мозга на фоне артериальной гипертонии. РКЖ 2002; 3: 46–50.
3. Н. В. Верещагин, З. А. Суслина, М. Ю. Максимова Артериальная гипертония и цереброваскулярная патология: современный взгляд на проблему. Кардиология 2004; 3: 4–8.
4. О. Д. Остроумова, Е. А. Смолярчук, Л. И. Фролова и др. Ингибиторы ангиотензин-превращающего фермента: что нового? Справочник поликлинического врача 2006; 2: 49–52.
5. В. Г. Лелюк, С. Э. Лелюк Ультразвуковая ангиопатия. Москва «Реальное время» 1999; 189 с.
6. В. И. Маколкин, В. И. Подколзов, В. И. Павлов и др. Состояние микроциркуляции при гипертонической болезни. Кардиология 2003; 5: 60–7.
7. Д. В. Преображенский, Б. А. Сидоренко, Е. М. Носенко и др. Головной мозг как орган-мишень у больных гипертонической болезнью и антигипертензивная терапия. Кардиология 2000; 1: 83–8.
8. А. М. Чернух, П. Н. Александров, О. В. Алексеев Микроциркуляция. Москва «Медицина» 1984; 110 с.
9. Agabiti-Rosei A, Ambrosioni E, Dal Palu C, et al. ACE inhibitor ramipril is more effective than the b-blocker atenolol in reducing left ventricular mass in hypertension. Result of the RASE (ramipril cardioprotective evaluation) study. J Hypertension 1995; 3: 1325–34.
10. Arnold JMO, Young S, Mathew J, et al. Prevention of Heart Failure in Patients in the Heart Outcomes Prevention Evaluation (HOPE) Study. Circulation 2003; 107: 1284–90.
11. Kaplan N. Clinical Altace Real-World Efficacy (CARE). The CARE Study: A postmarketing evaluation of ramipril in 11000 patients. Clin Ther 1996; 18(4): 658–70.
12. Lievre M, Gueret P, Gayet C, et al. on behalf of the HYCAR Study Group: Ramipril – induced regression of left ventricular hypertrophy in treated hypertensive individuals. Hypertension 1995; 25: 92–6.
13. Mahmud A, Felly J. Cardiovasc. Ther. Antihypertensive drugs and arterial stiffness. Exp Rev 2003; 1(1): 65–78.
14. Schmid-Schonbein GW. What is relevance of microcirculation in cardiovascular disease? In: microcirculation and cardiovascular disease. Lippincot Williams-Wilkins 2000; 1–13, 308.
Review
For citations:
Markova L.I., Radzevich A.E., Samsonova I.V., Vasilyeva E.V. Ramipril effects on cerebral blood flow and microcirculation in patients with essential arterial hypertension. Cardiovascular Therapy and Prevention. 2007;7(7):16-20. (In Russ.)
Views:
489
Email this article 
