Stable improvement in large artery compliance after long-term antihypertensive treatment with enalapril.

In 12 patients with mild or moderate essential hypertension we assessed by 2-D pulsed Doppler flowmetry the influence of a 6-month effective treatment with enalapril or atenolol on peripheral hemodynamics. The patients were studied in control conditions, at the end of the 6-month pharmacologic treatment, and 2 weeks after the withdrawal of the therapy. In spite of a comparable fall in blood pressure, the effects of the two drugs on forearm hemodynamics were quite different. Enalapril induced a fall in vascular resistance and an increase in brachial artery diameter, flow, and compliance, while atenolol failed to modify all these parameters. In the enalapril group the improvement in forearm vascular resistance and brachial artery compliance persisted after the 2-week washout period. This latter observation raises the possibility that enalapril may reverse structural changes in the large arteries.