Assessed of Angiotensin-Converting Enzyme Inhibitors Therapy Alone or Associated With Hydrochlorothiazide and/or Channel Calcium Blockers According to Applanation Tonometry

Objective: Angiotensin-converting enzyme inhibitors (ACE-I) are widely accepted as antihypertensive agents with beneficial effects on cardiovascular events. The aim of this study was to know the efficacy of the ACE-I therapy alone or associated with Hydrochlorothiazide (Hctz) and/or Channel Calcium Blockers (CCB) during assessment with the SphygmoCor System. Design and method: For this cross-sectional retrospective study, we recorded 109 hypertensives with normal kidney function, both sexes, treated with ACE-I alone (41%) and associated with Hctz and/or CCB. Women were 54 with a mean age of 68.5 years, and men 55 with a mean age of 64.3 years. The mean follow-up time for women and men was 33/38 months, respectively. Anthropological data, Systolic/Diastolic Blood Pressure, and Heart Rate were measured. Central Haemodynamic Parameters and the difference between normal levels and observed values of Augmentation Index with SphygmoCor System PVX were assessed, according method's standard by sex and age. The total sample of ACE-I therapy was evaluated, and after were divided into 4 groups: ACE-I alone or associated with Hctz, CCB, or both. The results of the ACE-I therapy alone group were compared with the other 3 groups. Mean and standard deviation were calculated. Statistical tests were two-sided and the alpha level was set at <0.05. Results: The systolic diastolic blood pressure (women-men 153.0/86.3-142.5/87.4 mmHg) and Central Haemodynamic Parameters of the total sample during ACE-I therapy were higher than normal, as were the values of the other 4 groups. When the group treated with ACE-I alone was compared with the groups of ACE-I associated with Hctz, BCC, or both, no statistically significant difference was observed. Only in the small group of women, the difference in augmentation index was normal when ACE-I was associated with Hctz and CCB. Probably associating Hctz or CCB with ACE-I could produce the phenomenon of “escape” of aldosterone with the consequent increase of cardiovascular volume and blood pressure. Conclusions: The systolic and diastolic blood pressure values and Central Haemodynamic Parameters during ACE-I therapy were higher than normal and when associated with Hctz, CCB, or both no benefit was observed.