What question did this study set out to answer?

To assess the acute and chronic effects of the ACE inhibitor spirapril on blood pressure and heart rate variability, autonomic activity, and systemic haemodynamics in essential hypertension.

January 1, 1996British Journal of Clinical Pharmacology

Effects of acute and chronic angiotensin converting enzyme inhibition by spirapril on cardiovascular regulation in essential hypertensive patients. Assessment by spectral analysis and haemodynamic measurements

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Why the study?

Does spirapril alter blood pressure variability and systemic haemodynamics in essential hypertensive patients?

Population

24 essential hypertensive patients

Comparison

Spirapril 3 mg (n=11) or 12 mg (n=13) for 8 weeks vs Placebo

Design

Other

Follow-up

8 weeks

Authors

DVDerk P. VeermanAmsterdam UMC Location Vrije Universiteit Amsterdam CDCaroline E. DoumaUtrecht University MJMARIE‐CECILE JACOBS

Discussion

Member takes

Implication

May support sympathetic modulation by ACE inhibition in hypertension; hypothesis-generating and should not yet change practice.

Key Points

To assess the acute and chronic effects of the ACE inhibitor spirapril on blood pressure and heart rate variability, autonomic activity, and systemic haemodynamics in essential hypertension.
Treated essential hypertensive patients with 3 mg (N=11) or 12 mg (N=13) spirapril for 8 weeks.
Evaluated short-term blood pressure and heart rate fluctuations via fast Fourier spectral analysis and systemic haemodynamics in supine and standing positions after the first dose and at 8 weeks.
In the 12 mg group, supine systolic mid-frequency (0.08–0.12 Hz) power decreased from 23 ± 10% on placebo to 11 ± 4% after the first dose (P < 0.01) and to 13 ± 6% after chronic treatment (P < 0.01), while 3 mg induced no changes.
Standing systolic mid-frequency power decreased from 38 ± 12% to 27 ± 9% after the first 12 mg dose (P < 0.01), but showed no significant decrease after chronic treatment (29 ± 13%).
Supine vascular resistance decreased by 16 ± 23% (3 mg) and 14 ± 19% (12 mg) after 8 weeks without altering heart rate, stroke volume, cardiac output, or high-frequency heart rate variability (0.15–0.40 Hz).

Structured PICO

Does spirapril alter blood pressure variability and systemic haemodynamics in essential hypertensive patients?

Population

24 essential hypertensive patients

Intervention

Spirapril 3 mg (n=11) or 12 mg (n=13) for 8 weeks

Comparator

Placebo

Outcome

Short-term blood pressure and heart rate fluctuations assessed by fast Fourier spectral analysis, and systemic haemodynamics in supine and standing positionsurrogate

Acute and chronic ACE inhibition with spirapril decreases mid-frequency blood pressure variability, suggesting an inhibitory effect on sympathetic vasomotor control without blunting cardiovascular reflexes.

Cite This Study

Veerman et al. (1996) studied this question.

synapsesocial.com/papers/6a70c80fa528af2d65c3bb71 https://doi.org/10.1111/j.1365-2125.1996.tb00158.x

Topics

Hypertension management

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Effects of acute and chronic angiotensin converting enzyme inhibition by spirapril on cardiovascular regulation in essential hypertensive patients. Assessment by spectral analysis and haemodynamic measurements

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Effects of acute and chronic angiotensin converting enzyme inhibition by spirapril on cardiovascular regulation in essential hypertensive patients. Assessment by spectral analysis and haemodynamic measurements

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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