Key result
Enalapril significantly reduced blood pressure and rate-pressure product at rest and during exercise without interfering with sympathetic adaptation to stress.
Why the study?
Does enalapril reduce blood pressure and affect sympathetic adaptation during exercise in patients with mild to moderate essential hypertension?
Does enalapril reduce blood pressure and affect sympathetic adaptation during exercise in patients with mild to moderate essential hypertension?
Enalapril effectively lowers blood pressure at rest and during exercise without impairing normal sympathetic adaptation to stress in hypertensive patients.
May support enalapril for exercise BP control in hypertension without sympathetic interference; extends observational data but leaves open randomized confirmation.
Vasodilator drugs reduce peripheral vascular resistance but lead to a secondary baroreflex-mediated chronotropic effect. After angiotensin-converting enzyme inhibition, blood pressure falls without associated tachycardia. In a previous study it was observed that enalapril increased vagal tone in essential hypertensive patients. In order to evaluate the effect of enalapril on sympathetic stimulation 10 mild to moderate hypertensive patients were studied during static (hand grip) and dynamic exercise (bicycle ergometer), after 2 weeks of placebo and after 1 month of treatment with 20-40 mg enalapril once daily. Enalapril significantly reduced blood pressure and the rate-pressure product at rest and at peak dynamic exercise. There was no effect on supine and maximal heart rate. Enalapril also significantly reduced blood pressure during hand grip, but did not interfere with the rate of the increase. Thus, enalapril does not seem to interfere with sympathetic adaptation to stress.
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Fariello et al. (1989) studied Mild to moderate essential hypertension (n=10). Enalapril vs. Placebo was evaluated on Blood pressure and rate-pressure product at rest and during static and dynamic exercise. Enalapril significantly reduced blood pressure and rate-pressure product at rest and during exercise without interfering with sympathetic adaptation to stress.
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