PP.13.19] MONOTHERAPY WITH RILMENIDINE PRODUCES AN EFFECTIVE BLOOD PRESSURE CONTROL AND IMPROVES ECHOCARDIOGRAPHIC VARIABLES IN YOUNG MILD TO MODERATE HYPERTENSIVES

Abstract

Objective: Rilmenidine is a new centrally acting antihypertensive agent with selective agonist activity at imidazoline I1 receptors from the brain with less adverse effects than other centrally acting sympatholytic drugs. In previous studies, Rilmenidine proved effective antihypertensive efficacy regardless of the age of patients. It is especially effective in patients with sympathetic overstimulation. The aim of this study was to evaluate the antihypertensive efficacy of rilmenidine and its effects on left ventricular hypertrophy and diastolic function in young patients with mild to moderate hypertension. Design and method: We performed a prospective study, lasting 3 months, in which 42 patients younger than 55 years old, (medium age 47.9 ± 5.6years), received once a day 1 mg rilmenidine. Diastolic left ventricular function was assessed by the following Doppler parameters: early (E) and late (A) peak velocities, E/A ratio, isovolumic relaxation time (IVRT), and deceleration time of E velocity (DT). Left ventricular mass index (LVMI) and diastolic function were determined at baseline and after 3 months. Blood pressure and heart rate were monitored at baseline and every month. Patients were requested to subjectively estimate their state as excellent, good, satisfactory and unsatisfactory. Results: After 3 months of therapy, systolic BP was reduced from 157.9 ± 13.6 mmHg to 130.1 ± 11.4 mmHg (p < 0.005) and diastolic BP from 97.6 ± 6.8 mmHg to 82.6 ± 6.7 mmHg (p < 0.005). Heart rate was reduced from 86.4 ± 6.6 bpm to 71.2 ± 4.4 bpm. LVMI decreased from 131.5 ± 3.5 g/m2 to 113.4 ± 3.6 g/m2 (p < 0.001). E/A ratio increased from 0.86 ± 0.24 to 1.02 ± 0.14 (p < 0.002). IVRT decreased from 118 ± 11 ms to 98 ± 10 ms (p < 0.001) and DT decreased from 216 ± 21 ms to 187 ± 17 ms (p < 0.002). 83.3% from the patients were controlled after 3 months of therapy. Treatment was well tolerated. None of the hypertensives estimated his state as unsatisfactory. Conclusions: Rilmenidine can be regarded as an effective and safe therapeutic possibility in mild/moderate young hypertensives. Therapy with Rilmenidine proved a good control of blood pressure, rich the therapeutic target, and was accompanied by the regression of cardiac hypertrophy and improvement in left ventricular diastolic function.