scholarly journals Impact of long-term therapy with eprosartan on the structural and functional state of the heart and large vessels and on the autonomic regulation of circulation in patients with arterial hypertension

Author(s):  
O. I. Yakovleva ◽  
O. V. Mamontov ◽  
A. N. Yakovlev ◽  
N. V. Vakhromeyeva ◽  
A. O. Konradi

To examine the effects of eprosartan on the remodelling of the heart and large vessels, on endothelial dysfunction and autonomic circulatory regulation in patients with hypertensive disease, thirteen patients were included into the study: Doppler echocardiographic study and evaluation of left ventricular diastolic function were performed on a Vingmed CFM800 apparatus: the thickness of the carotid intima-media complex and the diameter of the brachial artery were determined on the same apparatus using a 7.5-MHz transducer in the reactive hyperemia test. Automatic balance was evaluated by the spectral assay of cardiac rhythm variations. The cardiopulmonary component of baroreflex was also tested. Blood pressure normalized in 3 patients following 24 weeks of therapy with eprosartan in a daily dose of 600 mg. Two patients were excluded due to therapeutic inefficiency. In the remaining patients, the antihypertensive effect was incomplete. The mass of the left myocardial myocardium decreased by 10.8%. there was an increase in brachial arterial dilatation in the reactive hyperemia test. The variations of cardiac rhythm were not significantly changed, the baroreflex tended to be decreased. Thus, long-term eprosartan therapy improves the structural and functional state of the heart and vessels and fails to affect the autonomic regulation of circulation.

2007 ◽  
Vol 292 (1) ◽  
pp. H175-H179 ◽  
Author(s):  
Dinko Susic ◽  
Jasmina Varagic ◽  
Jwari Ahn ◽  
Luis Matavelli ◽  
Edward D. Frohlich

Aldosterone has been implicated as one of the mediators of cardiovascular injury in various diseases. This study examines whether mineralocorticoid antagonism ameliorates or prevents the adverse cardiac effects of hypertension and aging. Male 22-wk-old spontaneously hypertensive rats (SHR) were divided into two groups, 15 rats in each. One group received no treatment; the other was given eplerenone (∼100 mg·kg−1·day−1). At the age of 54 wk, indexes of cardiovascular mass, systemic and regional hemodynamics, including coronary, left ventricular function, and myocardial collagen content, were determined in all rats. Hemodynamic studies were done in conscious rats. Arterial pressure was lowered only slightly in eplerenone-treated rats, and cardiac output and total peripheral resistance did not differ from control rats. Left and right ventricular and aortic mass indexes were unaffected by eplerenone; however, concentration of hydroxyproline in the right and left ventricle was decreased significantly ( P < 0.05) by eplerenone. This was accompanied by an improvement in left ventricular diastolic function and coronary hemodynamics. In conclusion, long-term therapy with the mineralocorticoid receptor antagonist eplerenone ameliorated adverse cardiac effects of both hypertension and aging in SHR. Thus reduction in myocardial fibrosis, paralleled by improvements in left ventricular function and coronary hemodynamics, was observed in eplerenone-treated SHR.


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