ANTIHYPERTENSIVE AND VASOPROTECTIVE EFFECTS OF FOSINOPRILE IN PATIENTS WITH ARTERIAL HYPERTENSION

Objective: evaluate antihypertensive and vasoprotective effects of fosinopril in patients with arterial hypertension with a high and very high risk of cardiovascular complications. Material and methods. The open study included 26 Grade 2 hypertensive patients with high and very high cardiovascular risk. Among them were 13 (50%) women, 13 (50%) men, the average age of which was 58.1 ± 10.3 years. Initially, all patients received hydrochlorothiazide diuretic therapy at a dose of 12.5 mg per day and various ACE inhibitors, but target blood pressure levels were not achieved. Fosinopril, an angiotensin converting enzyme (ACE) inhibitor (Monopril, VALEANT LLC, Russia), was administered to correct blood pressure for all patients instead of ACE inhibitors which they received earlier. The patients underwent a complete clinical and instrumental examination. The emphasis was placed on the study of the endothelial function by instrumental and laboratory methods. A test with endothelium-dependent vasodilatation (EDVD) was performed using method D. Celermajer; the total concentration of nitrate- and nitrite ions (NO2, NO3) in the blood serum was determined by the colorimetric method. The results of the examination were compared before administration of the drug and after 4 weeks of treatment. Results. 22 patients (85%) could achieve the target level of blood pressure (less than 140/90 mm Hg) after 8 weeks of fosinopril treatment. Daily monitoring of blood pressure showed a significant decrease in the variability of both systolic (SBP) and diastolic blood pressure (DBP). Initially, the dilatation reaction of the brachial artery was reduced in all patients and averaged to 6.8 ± 1.9%. The level of NO2 was 18.1 ± 0.9 μmol/l, NO3 – 28.8 ± 0.3 μmol/l. After 4 weeks of treatment, the EDVD increased to 7.5 ± 2.9%. The level of NO2 was 19.3 ± 0.4 μmol/l, NO3 – 38.75 ± 0.54 μmol/l. Conclusion. Fosinopril, an ACE inhibitor, had a pronounced antihypertensive effect, and improved endothelial function in patients with hypertension with a high and very high risk of cardiovascular complications after 4 weeks of treatment.

arterial hypertension, fosinopril, endothelial dysfunction

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