Vascular structure in the forearm and @entity291 after 6 months of angiotensin converting enzyme inhibition in elderly XXXX subjects with @entity4346 .

@entity1 @entity101 @entity9383 @entity4346 @entity291
OBJECTIVE: To investigate the effects of angiotensin converting enzyme inhibition on the structure of resistive arteries assessed from minimal vascular resistance in the forearm and the @entity291 and on left ventricular mass index of elderly @entity101 subjects with @entity4346 . DESIGN AND METHODS: We evaluated 23 elderly @entity1 [12 @entity1 and 11 @entity1 , aged 70 +/- 1 years (mean +/- SEM)] with essential @entity101 assessed with ambulatory blood pressure monitoring and @entity4346 before and at the end of 6 months' treatment with @entity9383 . Minimal vascular resistance was calculated as the ratio of mean arterial pressure to regional blood flow measured upon restoration of circulation after 13 min of ischaemia combined with exercise and taken as an index of resistive vessel structure (i.e. media:lumen ratio). RESULTS: Daytime ambulatory blood pressure had decreased from 164 +/- 2/95 +/- 1 to 147 +/- 3/86 +/- 2 mmHg (P < 0.001) and left ventricular mass index decreased from 138 +/- 4 to 120 +/- 5 g/m2 (P < 0.001) at the end of treatment. Minimal vascular resistance in the forearm had decreased from 3.1 +/- 0.3 to 2.4 +/- 0.2 mmHg/ml per 100 ml per min (P < 0.01) whereas we observed no change in minimal vascular resistance in the @entity291 after treatment (4.6 +/- 0.7 versus 4.2 +/- 0.4 mmHg/ml per 100 ml per min, NS). The decrease in minimal vascular resistance in the forearm was correlated significantly to the fall in 24 h ambulatory mean arterial pressure (r = 0.58, P < 0.01). Changes in left ventricular mass index were not correlated to those in ambulatory blood pressure or to those in minimal vascular resistance in the forearm. CONCLUSIONS: A 6-month reduction in blood pressure under @entity9383 treatment was associated with decreases in @entity4346 and in minimal vascular resistance in the forearm of elderly @entity101 @entity1 . Absence of structural changes in leg vasculature could be related to the greater arterial pressure prevalent in the lower limbs while @entity1 stood upright and, consequently, a proportionately smaller decrease in blood pressure, as well as greater structural changes and fibrous damage than those of the upper limbs.
