Vascular haemodynamic effects of perindopril in essential hypertension.

Perindopril is an orally active non-thiol angiotensin-converting enzyme (ACE) inhibitor that is hydrolysed by esterases to a biologically active diacid metabolite. Perindopril decreases plasma concentrations of angiotensin II, increases plasma renin activity and reduces systolic and diastolic blood pressure in patients with essential hypertension. Most data support the hypothesis that the beneficial haemodynamic effects of perindopril are caused by ACE inhibition and the consequent reduction in angiotensin II, which either directly or indirectly results in dilatation of peripheral vessels and reduced vascular resistance. The marked blood pressure reduction after perindopril administration in hypertensive patients has not been accompanied by significant changes in heart rate. Furthermore, the lack of reflex tachycardia does not appear to be related to a reduction in baroreceptor sensitivity.