Kidney Blood Press Res.
2005 Mar 1;28(2):111-116. Comparison of the Effects of Quinapril
and Losartan on Carotid Artery Intima-Media Thickness in Patients
with Mild-to-Moderate Arterial Hypertension.
Uchiyama-Tanaka Y, Mori Y, Kishimoto N, Fukui M, Nose A, Kijima
Y, Yamahara H, Hasegawa T, Kosaki A, Matsubara H, Iwasaka T.
Department of Medicine II, Kansai Medical University, Osaka, Japan.
Background: Ultrasonographic evidence of increased
carotid intima-media thickness (IMT) is known to be associated
with generalized atherosclerosis. Therapeutic blockade of the
renin-angiotensin system (RAS) with angiotensin-converting enzyme
(ACE) inhibitors reportedly reduces carotid IMT in humans. However,
there has been no head-to-head comparison of the effects of ACE
inhibitor and angiotensin receptor blocker (ARB), a newer type
of RAS inhibitor, on carotid IMT. Methods: 57 hypertensive patients
were randomly assigned to treatment with one of two antihypertensive
drugs: ACE inhibitor (quinapril; n = 25, group Q) or ARB (losartan;
n = 18, group L). Results: After 1 year of treatment, a similar
decrease in mean blood pressure was observed in all groups. Carotid
IMT was decreased significantly in group Q (10% decrease, p <
0.05) but did not change in group L. There were no significant
changes in other atherosclerotic factors between these two groups.
Conclusion: Our findings suggest that the antiatherosclerotic
effect of quinapril is more potent than that of losartan in hypertensive
patients. This effect appears unrelated to the drug's antihypertensive
action or to traditional atherosclerotic factors. Copyright (c)
2005 S. Karger AG, Basel.
Clin Cardiol. 2004 Aug;27(8):480-4. Effect of quinapril on the attenuated heart
rate recovery of type 2 diabetic subjects without known coronary
artery disease.
Sipahi I, Tekin G, Yigit Z, Guzelsoy D, Guven O.
Department of Cardiology, Cardiology Institute, Istanbul University,
Istanbul, Turkey.
BACKGROUND: Heart rate (HR) recovery at
1 min is a measure of the vagal reactivation that occurs after
cessation of exercise. Despite ample evidence about the association
of attenuated HR recovery with increased mortality, pharmacologic
modification of this predictor has not been shown. On the other
hand, angiotensin-converting enzyme (ACE) inhibitors are known
to have vagomimetic activity. HYPOTHESIS: We hypothesized that
ACE inhibition would increase HR recovery in a group of subjects
known to have reduced HR recovery, namely diabetics. METHODS:
Maximal treadmill exercise stress test was performed in 31 type
2 diabetic and 31 nondiabetic male subjects with similar age,
body mass index, and hypertensive status. None of the subjects
had known heart disease or evidence of myocardial ischemia during
the test. The diabetic subjects, after 2 weeks of treatment with
quinapril, underwent a second exercise test. A third test was
performed 2 to 3 weeks after cessation of quinapril treatment.
RESULTS: At baseline, despite similar exercise capacity, the diabetics
had a lower HR recovery at 1 min than nondiabetics (25 +/- 8 vs.
31 +/- 8 beats/min, p < 0.01). Quinapril significantly increased
HR recovery at 1 min in diabetics (25 +/- 8 beats/min at baseline
vs. 28 +/- 8 beats/min with quinapril vs. 25 +/- 7 beats/min off-therapy,
p < 0.01 by analysis of variance). CONCLUSIONS: The attenuated
HR recovery of type 2 diabetics can be improved by quinapril.
Whether the improvement in HR recovery with ACE inhibition can
lead to decreased mortality is currently unknown.
