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Changes in baroreflex sensitivity induced by cilazapril do not manifest in Valsalva and tachycardia ratios in hypertensives


, : Changes in baroreflex sensitivity induced by cilazapril do not manifest in Valsalva and tachycardia ratios in hypertensives. Journal of Medicine 27(1-2): 89-96

It has not been established whether treatment of hypertension with antihypertensive agents improves the impairment of baroreflex sensitivity found in hypertensive patients. We assessed the acute effect of cilazapril on the baroreflex sensitivity in 16 essential hypertensives. Baroreflex sensitivity was evaluated as BRS from the relationship between changes in arterial pressure and RR-interval of ECG obtained during phases 1-2 of Valsalva maneuver. Continuous arterial pressure was measured using the FINAPRES finger-cuff method during Valsalva maneuver. Valsalva ratio and tachycardia ratio were also calculated. Cilazapril (4 hours after single oral administration of 1 mg) reduced arterial pressure from 163 +- 3/86 +- 3 to 132 +- 5/72 +- 4 mmHg (supine) without affecting heart rate (71 +- 3 vs. 70 +- 2 bpm). Cilazapril improved BRS from 1.15 +- 0.22 to 1.71 +- 0.29 ms/mmHg (+49%, p lt 0,.05). However, cilazapril did not affect Valsalva ratio (1.19 +- 0.05 vs. 1.19 +- 0.04) or tachycardia ratios (0.88 +- 0.02 vs. 0.90 +- 0.03). These results may suggest that cilazapril improves blunted baroreflex function within a new pressure range in hypertensives showing an enhancement of parasympathetic tone, and that Valsalva and tachycardia ratios are not always sensitive to the change in baroreflex sensitivity.

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PMID: 8863180


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