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Luigina Guasti, Luca T. Mainardi, Danilo Zanotta, Maria R. Petrozzino, Alessio Diolisi, Deborah Garganico, Giovanni Gaudio, Cinzia Simoni, Andrea Maffiolini, Anna M. Grandi, Sergio Cerutti, Achille Venco, P-355: Autonomic function and baroreflex sensitivity during enalapril or losartan treatment in essential hypertensive patients: A cross-over study, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 149A, https://doi.org/10.1016/S0895-7061(01)01951-3
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Abstract
To investigate the potential role of angiotensin II and/or the bradykinin system on the autonomic function and baroreflex sensitivity, heart rate and blood pressure variability were evaluated in hypertensive patients before anti-hypertensive therapy and during enalapril or losartan treatment (cross-over study).
Heart rate variability was assessed in a resting condition by power spectrum analysis to calculate the Low Frequency (LF) power, High Frequency (HF) power and LF/HF ratio in 19 hypertensive patients and 23 normotensive controls. Moreover, the coherence between the tachogram and the systogram was evaluated, and the baroreflex gain (alpha-LF index) was obtained. Then a 24-h ambulatory blood pressure monitoring was performed. The 19 hypertensive patients were randomized to either enalapril or losartan treatment, and after 2 months were re-submitted to the RR variability and baroreflex study and to blood pressure monitoring. The subjects then crossed to the other anti-hypertensive treatment and were re-evaluated after an additional two months.
No significant difference was found either in LF power and HF power and LF/HF ratio between normotensive and hypertensive subjects whereas a slight though significant difference was observed in the alpha-LF index. In hypertensive patients, both the treatments with enalapril and losartan reduced blood pressure and had no effect on heart rate. No significant change was observed in autonomic balance or in baroreflex sensitivity during the two anti-hypertensive treatments.
Conclusions. In hypertensive patients, the angiotensin system or bradykinins do not seem to have any modulatory effect on the sympathetic/parasympathetic control of blood pressure in a resting condition. Moreover, since no change in heart rate was documented during the two anti-hypertensive treatments in presence of a reduction of blood pressure values, a resetting in baroreflex function was observed. However, baroreflex sensitivity was not influenced either by ACE-inhibition or AT1 receptor blockade.
