Kohno M, Yokokawa K, Yasunari K, Kano H, Minami M, Hanehira T, Yoshikawa J
First Department of Internal Medicine, Osaka City University Medical School, Japan.
Int J Clin Pharmacol Ther. 1997 Jan;35(1):38-42.
Plasma concentrations of atrial and brain natriuretic peptides (ANP and BNP) are high in patients with hypertension and congestive heart failure. The present study examined changes in plasma ANP and BNP concentrations during 1 year of monotherapy with enalapril in elderly hypertensive patients with left ventricular (LV) hypertrophy. Eight elderly hypertensive patients with LV hypertrophy were treated with enalapril for 1 year, during which time serial changes were recorded in LV mass index, LV systolic function, and plasma concentrations of ANP and BNP. Enalapril maintained systolic and diastolic blood pressure in the normal range for over 1 year. Treatment significantly reduced posterior wall thickness at 6 months, and more so at 1 year, and tended to reduce septal wall thickness and LV mass index at 1 year. LV ejection fraction was slightly but significantly increased at 1 year. Plasma ANP and BNP, which were markedly elevated at study entry, both decreased after 1 year of enalapril. These results suggest that 1 year of treatment with enalapril caused both a modest regression of LV hypertrophy and a modest improvement in LV systolic function in our selected group of elderly hypertensive patients. The drug reduced elevated plasma ANP and BNP levels but did not alter BUN and serum creatinine levels. Enalapril appears to be useful for the treatment of elderly hypertensive patients with LV hypertrophy.
高血压和充血性心力衰竭患者的心房利钠肽（ANP）和脑利钠肽（BNP）血浆浓度较高。本研究检测了老年左心室（LV）肥厚高血压患者接受依那普利单药治疗1年期间血浆ANP和BNP浓度的变化。8例老年LV肥厚高血压患者接受依那普利治疗1年，在此期间记录LV质量指数、LV收缩功能以及ANP和BNP血浆浓度的系列变化。依那普利在1年多的时间里将收缩压和舒张压维持在正常范围内。治疗6个月时后壁厚度显著降低，1年时降低更明显，且1年时室间隔厚度和LV质量指数有降低趋势。1年时LV射血分数略有但显著增加。研究开始时显著升高的血浆ANP和BNP在依那普利治疗1年后均下降。这些结果表明，在我们所选的老年高血压患者组中，依那普利治疗1年导致LV肥厚有适度消退，LV收缩功能有适度改善。该药物降低了升高的血浆ANP和BNP水平，但未改变血尿素氮和血清肌酐水平。依那普利似乎对治疗老年LV肥厚高血压患者有用。
