Cheung B M, Lau C P
Department of Medicine, University of Hong Kong, Hong Kong.
Br J Clin Pharmacol. 1999 Feb;47(2):179-87. doi: 10.1046/j.1365-2125.1999.00873.x.
Left ventricular hypertrophy is a powerful predictor of cardiovascular morbidity and mortality. We tested the hypothesis that fosinopril, an angiotensin-converting enzyme inhibitor, reduces left ventricular mass in hypertensive patients.
Thirty-three patients with untreated mild essential hypertension were randomised to treatment with oral fosinopril (10 mg-20 mg daily) or placebo for 12 weeks. The primary outcome measure was the change in left ventricular mass index determined by echocardiography.
Diastolic blood pressure changed from 95.5+/-2.1 mmHg at baseline to 96.6+/-2.8 mmHg at the final visit in control patients and changed from 96.6+/-2.3 mmHg to 91.5+/-3.0 mmHg in patients treated with fosinopril (P= 0.04). Systolic blood pressure changed from 147.4+/-3.2 mmHg at baseline to 152.7+/-4.4 mmHg at the final visit in control patients and changed from 157.6+/-5.1 mmHg to 149.1+/-6.1 mmHg in patients treated with fosinopril (P=0.02). Fosinopril reduced diastolic pressure by 6.3 (95%CI 0.3-12.4) mmHg and systolic pressure by 13.3 (95%CI 2.7-23.8) mmHg compared with placebo. The left ventricular mass index changed from 110.0+/-8.3 gm(-2) to 113.1+/-8.7 g m(-2) in the control patients and changed from 120.8+/-5.8 g m(-2) to 109.0+/-7.5 g m(-2) in patients treated with fosinopril (P=0.02). Fosinopril reduced left ventricular mass index by 14.9 (95%CI 2.2-27.6) g m(-2) compared with placebo. There was no significant change in the left ventricular systolic or diastolic function, nor were there any significant changes in plasma electrolytes and renal function.
Treatment with fosinopril for 12 weeks reduced left ventricular mass significantly in hypertensive patients.
左心室肥厚是心血管疾病发病率和死亡率的有力预测指标。我们检验了以下假设：血管紧张素转换酶抑制剂福辛普利可降低高血压患者的左心室质量。
33例未经治疗的轻度原发性高血压患者被随机分为两组，分别口服福辛普利（每日10毫克至20毫克）或安慰剂，治疗12周。主要观察指标是通过超声心动图测定的左心室质量指数的变化。
对照组患者的舒张压从基线时的95.5±2.1毫米汞柱变为末次访视时的96.6±2.8毫米汞柱，而接受福辛普利治疗的患者则从96.6±2.3毫米汞柱变为91.5±3.0毫米汞柱（P = 0.04）。对照组患者的收缩压从基线时的147.4±3.2毫米汞柱变为末次访视时的152.7±4.4毫米汞柱，接受福辛普利治疗的患者则从157.6±5.1毫米汞柱变为149.1±6.1毫米汞柱（P = 0.02）。与安慰剂相比，福辛普利使舒张压降低了6.3（95%可信区间0.3 - 12.4）毫米汞柱，收缩压降低了13.3（95%可信区间2.7 - 23.8）毫米汞柱。对照组患者的左心室质量指数从110.0±8.3克/平方米变为113.1±8.7克/平方米，接受福辛普利治疗的患者则从120.8±5.8克/平方米变为109.0±7.5克/平方米（P = 0.02）。与安慰剂相比，福辛普利使左心室质量指数降低了14.9（95%可信区间2.2 - 27.6）克/平方米。左心室收缩或舒张功能无显著变化，血浆电解质和肾功能也无显著变化。
福辛普利治疗12周可显著降低高血压患者的左心室质量。
