Exercise Capacity (By Bicycle Exercise Test) And Cell Membrane Lipid Alterations Under Captopril Treatment In Patients With Both Essential Hypertension And Coronary Heart Disease

ACE-inhibitors are accepted in the therapy of hypertension as well as in congestive heart failure, The antiischemic effect results from a number of different already investigated mechanisms, But the effects of ACE-inhibition on changes of cell membranes is more or less unknown especially the effects on lipid disorders, A prospective study was carried out on 15 male patients (40-58 gears of age) with mild to moderate hypertension (diastolic blood pressure at rest 95-115 mmHg) and stable coronary heart disease with normal left ventricular ejection fraction of 60% +/- 1%, After at least 4 days without any antihypertensive drug therapy, a monotherapy with captopril (75-100 mg/day) was started, The physical workload was determined at the beginning, after 2 weeks resp, after 2 months along with the parameter of lipds: cholesterol in the membrane of erythrocytes and thrombocytes and the profile of phospholipids.The workload and the time of performing were significantly increased under captopril at both measure points, The number of pathological exercise tests decreased from 60% to 27% after 2 weeks resp, to 13% after 2 months.Cholesterol in the plasma decreased significantly (p < 0.001) whereas only in the second meek the cholesterol in the membrane of the erythrocytes was lowered, No changes were found in the fractions of phospholipids.