August 5, 1997Circulation
Comparative Effects of Enalapril and Verapamil on Myocardial Blood Flow in Systemic Hypertension
Key result
Verapamil significantly increased myocardial blood flow during pacing and after dipyridamole in hypertensive patients, whereas enalapril did not significantly change MBF.
Why the study?
Does verapamil improve myocardial blood flow compared to enalapril in hypertensive subjects with normal coronary arteries?
Population
20 hypertensive subjects with normal coronary arteries
Comparison
Verapamil 240 to 480 mg/d for 6 months vs Enalapril 10 to 40 mg/d for 6 months
Design
RCT, randomly assigned
Follow-up
6 months
Authors
Discussion
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Implication
Verapamil may be preferred over enalapril for coronary microvascular function in hypertension; extends evidence distinguishing CCB from ACEI effects on MBF.
Study Design
Type
RCT (n=20)
Randomization
randomly assigned
Structured PICO
Does verapamil improve myocardial blood flow compared to enalapril in hypertensive subjects with normal coronary arteries?
P
Population
20 hypertensive subjects with normal coronary arteries
I
Intervention
Verapamil 240 to 480 mg/d for 6 months
C
Comparator
Enalapril 10 to 40 mg/d for 6 months
O
Outcome
Myocardial blood flow (MBF) at rest, during pacing tachycardia, and after dipyridamole measured by positron emission tomography and 13N-ammonia at 6 monthssurrogate
In hypertensive patients, long-term verapamil therapy improves coronary microcirculatory function and myocardial blood flow response to stress, whereas enalapril does not.
Cite This Study
Parodi et al. (1997) conducted an RCT in Systemic Hypertension (n=20). Verapamil vs. Enalapril 10 to 40 mg/d was evaluated on Myocardial blood flow (MBF) at rest, during pacing tachycardia, and after dipyridamole. Verapamil significantly increased myocardial blood flow during pacing and after dipyridamole in hypertensive patients, whereas enalapril did not significantly change MBF.