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Effect of the angiotensin-converting enzyme inhibitor imidapril on reactive hyperemia in patients with essential hypertension: relationship between treatment periods and resistance artery endothelial function

Yukihito Higashi, MD, PhD^*, Shota Sasaki, MD^*, Keigo Nakagawa, MD^*, Hideo Matsuura, MD, PhD^*, Goro Kajiyama, MD, PhD^* and Tetsuya Oshima, PhD

^* First Department of Internal Medicine, Hiroshima University School of Medicine, Hiroshima, Japan
Department of Clinical Laboratory Medicine, Hiroshima University School of Medicine, Hiroshima, Japan

View larger version (16K): [in a new window]   Figure 1 Line graphs show forearm blood flow at rest and during reactive hyperemia in patients with essential hypertension and in normotensive control subjects. Reactive hyperemia was impaired in hypertensive patients compared with normotensive subjects.

View larger version (16K): [in a new window]   Figure 2 Bar graphs show maximal forearm blood flow after sublingual administration of nitroglycerin (NTG) in patients with essential hypertension and in normotensive control subjects. The NTG-induced vasodilation was similar between the two groups.

View larger version (20K): [in a new window]   Figure 3 Line graphs show forearm blood flow at rest and during reactive hyperemia in patients with essential hypertension before (0 weeks) and after 2, 4, 8, 12, 24 and 48 weeks of treatment with the angiotensin-converting enzyme inhibitor imidapril and the calcium antagonist amlodipine. Imidapril augmented RH after 12 weeks of treatment. There was no significant difference in RH at 12, 24 and 48 weeks. Amlodipine did not alter RH for each treatment period.

View larger version (28K): [in a new window]   Figure 4 Bar graphs show maximal forearm blood flow after sublingual administration of nitroglycerin (NTG) in patients with essential hypertension before (0 weeks) and after 2, 4, 8, 12, 24 and 48 weeks of treatment with the angiotensin-converting enzyme inhibitor imidapril and the calcium antagonist amlodipine. The NTG-induced vasodilation was similar for all treatment periods.

View larger version (20K): [in a new window]   Figure 5 Line graphs show forearm blood flow at rest and during reactive hyperemia (RH) after infusion of NG-monomethyl-L-arginine (L-NMMA) in patients with essential hypertension before (0 weeks) and after 12 weeks of treatment with the angiotensin-converting enzyme inhibitor imidapril and the calcium antagonist amlodipine. L-NMMA abolished the enhancement of RH in hypertensive patients treated with imidapril.