The effects of monotherapy or combined therapy with an angiotensin converting enzyme inhibitor following initial treatment with calcium channel blockers on residual cardiovascular abnormalities.

Abstract	The effects of sequential therapy with angiotensin-converting enzyme inhibitor (cilazapril) on left ventricular (LV) mass, LV diastolic function, and carotid artery distensibility were evaluated in 90 hypertensive patients whose blood pressure controlled below 140/90 mmHg with a calcium channel blocker monotherapy. The possibility of predicting the efficacy of cilazapril based on evaluation of biochemical and genetic markers of the renin-angiotensin system was examined. Before cilazapril therapy, LV diastolic function and carotid artery distensibility were significantly impaired in 32 patients with residual LV hypertrophy compared with patients without LV hypertrophy. Cilazapril improved the LV mass in these patients with LV hypertrophy and improved LV diastolic function in a subset of 20 patients with elevated plasma renin activity. Patients with residual LV hypertrophy accompanied by cardiovascular functional abnormalities. Subsequent treatment with cilazapril significantly improved LV morphology and function in those with residual LV hypertrophy or elevated plasma renin activity.
Authors	H Tomiyama, Y Kimura, Y Sakuma, K Matuno, H Yoshida, N Doba
Journal	Clinical and experimental hypertension (New York, N.Y. : 1993) (Clin Exp Hypertens) Vol. 22 Issue 5 Pg. 493-506 (Jul 2000) ISSN: 1064-1963 [Print] England
PMID	10937840 (Publication Type: Journal Article)
Chemical References	Angiotensin-Converting Enzyme Inhibitors Calcium Channel Blockers Cilazapril Renin
Topics	Aged Angiotensin-Converting Enzyme Inhibitors (administration & dosage) Calcium Channel Blockers (administration & dosage) Carotid Arteries (drug effects, pathology, physiopathology) Case-Control Studies Cilazapril (administration & dosage) Drug Therapy, Combination Female Humans Hypertension (drug therapy, pathology, physiopathology) Hypertrophy, Left Ventricular (drug therapy, pathology, physiopathology) Male Middle Aged Renin (blood) Renin-Angiotensin System (genetics, physiology) Ventricular Function, Left (drug effects)

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