Time course of the effects of temocapril on cardiovascular structure and function in patients with essential hypertension

To investigate the time course of cardiovascular structural changes in patients with essential hypertension after angiotensin-converting enzyme (ACE) inhibition, we determined left ventricular structure, minimal vascular resistance in the forearm as an index of resistance vessel structure and stiffness beta of carotid artery in 15 essential hypertensive subjects during a placebo period and after 2, 6, and 12 months of temocapril treatment. Blood pressure decreased within 2 weeks, and the antihypertensive effects were noted throughout the 12-month administration period. Left ventricular mass index decreased significantly after 2 months (120 +/- 12 to 106 +/- 9 g/m(2); p < 0.01) and was normalized after 12 months (88 +/- 6 g/m(2)). Postischemic minimal vascular resistance in the forearm decreased gradually from 2.1 +/- 0.5 to 1.6 +/- 0.4 PRU at month 12 of temocapril treatment. In contrast, increased stiffness index beta of carotid artery was not altered during a I-year treatment period (11.4 +/- 4.9 to 11.6 +/- 3.8 at month 12 of treatment). These data indicated that the regression of structural changes of left ventricle and arterioles occurred gradually and progressively for 1-year treatment with ACE inhibition, but large arteries were not affected.