COMPARISON OF THE HEMODYNAMIC-EFFECTS OF LISINOPRIL AND LISINOPRIL PLUS HYDROCHLOROTHIAZIDE DURING REST AND ORTHOSTATIC STRESS

The haemodynamic effects accompanying blood pressure reduction following the use of lisinopril alone or lisinopril plus hydrochlorothiazide in a fixed dose combination were compared in 26 patients with mild to moderate essential hypertension, Haemodynamic assessments, carried out using impedance cardiography, showed a decrease in systemic vascular resistance index after the final week of treatment with lisinopril alone. There were no significant changes in cardiac index or heart rate. On treatment with the combination of lisinopril and hydrochlorothiazide, the systemic vascular resistance index fell further, again without significant change in cardiac index or heart rate. Orthostatic stress produced no different behaviour in the response of systolic and diastolic blood pressures, cardiac index, stroke volume index, or systemic vascular resistance index on lisinopril treatment compared with placebo. There was, however, a trend toward an increase in heart rate. Similar behaviour was noted for treatment with the combination of lisinopril and hydrochlorothiazide, although there was a trend towards a greater decrease in systolic blood pressure and a smaller increase in systemic vascular resistance index when patients stood. There appears to be no qualitative difference in the underlying haemodynamic mechanisms of blood pressure reduction in patients treated with lisinopril alone or with lisinopril combined with hydrochlorothiazide. (C) 1995 Wiley-Liss, Inc.