Endothelial and Metabolic Effects of Perindopril in Patients With Essential Hypertension

Objective: to elucidate endothelial and metabolic effects of perindopril and their interaction in patients with uncomplicated essential hypertension. Methods: The study involved 30 patients treated with perindopril (5-10 mg/day) for 3 months. The following parameters were registered at baseline and at the end of the study: body mass index, waist circumference, blood lipids and glucose, flow-mediated vasodilation (FMVD) of brachial artery assessed by ultrasound. Results: Treatment with perindopril was associated with significant improvement of FMVD (6.7 +/- 4.1% versus 8.7 +/- 5.4% at the end of the study, p<0.05) as well as decrease of blood triglycerides (-18%, p<0.05) and glucose (-9%, p<0.01) with no significant changes of other metabolic parameters. Correlation analysis showed no relationship between changes of FMVD and blood pressure during the study (r=-0.14, p=0.42 (sic) r=-0.13, p=0.46 for systolic and diastolic blood pressure, respectively) whereas inverse association was observed with changes of blood glucose (r=-0.50, p<0.01). Conclusions: Thus our data confirm the ability of perindopril to restore impaired endothelial function in patients with essential hypertension independently of blood pressure reduction and make possible to propose its positive metabolic effect relative to changes associated with insulin resistance. It seems that endothelial effect of perindopril may in part be related to diminished adverse influence of metabolic changes on vascular wall.