P-51: The lisinopril effects upon blood pressure diurnal rhythm and left ventricular myocardial mass in essential hypertension

to study the arterial blood pressure (BP) level, left ventricular (LV) hyper- trophy and LV function dynamics in essential hypertension (EH) patients (pts) during long term angiotensin converting enzyme inhibition lisinopril (L) monotherapy ( M). we investigated 23 EH pts, which were divided into two group: 1-st with “dipper” BP diurnal rhythm type (BPDRT) (n=14 pts), 2-nd – “non-dipper” BPDRT (n=9). The BP level was studied by 24-hour ambulatory BP monitoring (ABPM), LV hypertrophy and LV function (LVF) – by echocardiography M-mode and B-mode regiments. Before L treatment the diurnal “dipper” BP type was in 14 EH pts, “non-dipper” type – in 9 EH pts. The LV myocardial mass index (LVMMI) was more than 125 gr/m2 in13 pts, 10 pts had it less than 125 gr/m2. The examination was made before and after LM in dosage 10–20 mg daily during 6–7 mouths. the LVMMI decreasing on 10 mg/m2 and more during LM treatment were in 9 pts (all of them have LVH initial, others – LVMMI during investigate time don't signification change). The LVMMI decrease was calling by LV posterior wall thickness (PWT), interventricular septum thickness (IVST) and LV end-diastolic diameter (EDD) decrease. The PWT, IVST and EDD dynamics were depend from LV remodelling type in certain measure. We observed the velocity of circumferential fiber shortening (Vcf) increase in all groups from (1,16±0,08 to 1,28±0,08)sec−1 in with LVMMI decrea sing and from (1,27±0,05 to 1,40±0,070)sec−1 without LVMMI change. The LM lead up to middle-diurnal, middle daily and middle-night BP meaning, their variability decreasing without growth morning dependence from LWMMI dynamics and from initial BPDRT.The diurnal index was decreased (p0,05) and don't change significantly in “dipper” pts (p>0,05).During repeat investigation the “dipper” type was in 20 pts,“ non-dipper” – in 3 pts. in EH pts the long-term L intake contribute BPDRT normalization in “non-dipper” majority pts and hasn't influence in “dipper” pts upon its character. The LVMMI important decrease was only in pts with initial LV hypertrophy. The LV regression character depended on initial LV remodelling type. The L treatment con tribute LV contractility increase without LVMMI dynamics dependence. Am J Hypertens (2004) 17, 50A–50A; doi: 10.1016/j.amjhyper.2004.03.125