[Effect of hypotensive drugs on painless ischemia of the myocardium and diastolic function of the left ventricle].

UNLABELLED: Aim of the study was comparative assessment of hypotensive, antiischemic efficacy and effect on left ventricular (LV) diastolic function of calcium antagonists, angiotensin converting enzyme inhibitor and blockers of beta-adrenoreceptors. RESULTS: The data obtained evidence that at monotherapy most pronounced lowering of arterial pressure is observed during use of verapamil CR or amlodipine. Therapy with all studied drugs led to significant decrease of number of episodes of ST-segment depressions, their duration and amplitude during 24 hours. Greatest decrease of frequency of episodes of ST-segment depression was observed during therapy with heart rate reducing calcium antagonists. Disturbed LV diastolic function improved under action of calcium antagonists and beta-adrenoblockers did not change during therapy with angiotensin converting enzyme inhibitor. Diminishment of severity of disturbance of diastolic function under influence of pulse slowing calcium antagonists was associated in the first place with augmentation of LV filling in the first phase of diastole, but during therapy with amlodipine and beta-adrenoblockers - with decrease of contribution of systole of the left atrium. beta-adrenoblockers and diltiazem improved LV diastolic function in patients with episodes of painless myocardial ischemia. CONCLUSION: Comparative assessment of hypotensive action of preparations from three groups revealed that greatest lowering of arterial pressure occurred during monotherapy with verapamil SR and amlodipine. The stadied drugs differently affected damage of a target organ - the heart - in patients with AH.

[Comparative effects of amlodipine (stamlo) and enalapril (enam) on arterial pressure, painless myocardial ischemia and diastolic function of left ventricle in patients with arterial hypertension]. / Sravnitel'naia otsenka vliianiia amlodipina (stamlo) i énalaprila (énama) na uroven' arterial'nogo davleniia, bezbolevuiu ishemiiu miokarda i diastolicheskuiu funktsiiu levogo zheludochka u bol'nykh arterial'noi gipertoniei.

43 patients with mild and moderate arterial hypertension received monotherapy with either stamlo (Dr. Reddy's laboratories, India) in a daily dose 9.5 +/- 0.5 mg (n = 33), or enam (n = 26) in a daily dose 28 +/- 1.5 mg, or stamlo treatment was followed in 10 days by enam (n = 16). Before and after the treatment 24-h monitoring was made of arterial pressure, left ventricular diastolic function and silent myocardial ischemia. Adequate lowering of arterial pressure was observed in 90 and 77% of patients after stamlo and enam treatment, respectively. Stamlo showed more potent antiischemic action and had a positive effect on left ventricular filling.