V.V. Batushkin, M. Ashdary, A.I. Gema, N.A. Komarevych.Changes of cardiac hemodynamics and proinflammatory cytokine levels under treatment with zofenopril and lisinopril in postinfarction patients with concomitant arterial hypertension

The aim – to study the effect of 6-months treatment with zofenopril and lisinopril upon clinical course of hypertension in the postinfarction period. The dynamics of blood pressure, intracardiac hemodynamics parameters, endothelial function and laboratory inflammatory factors were examined in 181 patient after acute myocardial infarction with ST segment elevation with concomitant moderate or severe hypertension, age 67.3±3.7 years. Six-months antihypertensive therapy with zofenopril was not inferior to of lisinopril, reducing systolic blood pressure by 20.4 %, diastolic blood pressure at night by 17.9 %, systolic blood pressure variability by 61.8 % (Р=0.003), systolic blood pressure time index by 44.6 %, diastolic blood pressure time index by 40 %. Prevention of progression of left ventricular remodeling using zofenopril was due to the improvement of left ventricular systolic dysfunction (increase of ejection fraction by 11.8 %, Р<0.05). Zofenopril prevented left ventricular dilation better than lisinopril and decreased left ventricular mass in 69.2 % patients. Prolonged use of both drugs influenced dynamics of pro-inflammatory cytokines, significantly reducing indicators of systemic inflammation. Zofenopril restored vascular endothelial function earlier and faster than lisinopril. This effect was characterized by significant increase of circulation volume velocity by 42.3 %, vascular reactivity index by 23.1 %. Taking into account small number of side effects, zofenopril in 60 mg daily is better tolerated than lisinopril 20 mg daily, causing 31.7 % less cases of hypotension.

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