P4.07 Influence of Long-Acting Isosorbide-5-Mononitrate Administration on Large Arterial Stiffness in Patients with Essential Hypertension

AIM of this study was to evaluate the clinical efficacy of long-acting nitrates, isosorbide-5-mononitrate (ISMN), in addition to ACE inhibitor on artery stiffness in patients with essential hypertension. MATERIALS AND METHODS. 40 hypertensive patients (mean age 61.3 ± 7.4 years, 9 male, 31 female, mean SBP/DBP = 158,1 ± 17,9/91,7 ± 9 mmHg) received moexipril in individual titrated doses (mean dose 11,7 ± 4,8 mg daily) for 3 months. 20 patients, which retained SBP > 140 and/or DBP > 90 mmHg, received additional ISMN (50 mg daily) for 4 weeks. Other patients formed the control group. Large arterial stiffness was assessed by automatic noninvasive measurement of the brachial-ankle pulse wave velocity (baPWV). Endothelial function was calculated based on flow-mediated dilatation (FMD) parameters. RESULTS. The 3 months treatment of ACE inhibitor produced a significant reduction in systolic (−26,6 mmHg) and diastolic BP (−10,2 mmHg), baPWV (−1,1 m/s) and increase of FMD (+1,5%). Administration with ISMN of 20 pts, without reaching BP target level on treatment of ACE inhibitor, did not to lead to significant decreasing of SBP(−1,3 mmHg), DBP(−2,1mmHg) and baPWV (+0,3 m/s). There was no difference in BP and baPWV in ISMN + ACEI treatment group compared with control group (ACEI only). CONCLUSION. Addition of ISMN to ACE inhibitor has no beneficial impact on BP and improvement of arterial stiffness in patient with essential hypertension.