Immediate and short-term cardiovascular effects of fosinopril, a new angiotensin-converting enzyme inhibitor, in patients with essential hypertension

Immediate and short-term cardiovascular effects of a new angiotensin-converting enzyme inhibitor, fosinopril, were assessed in 10 patients with mild to moderate essential hypertension. Administration of a 10 mg oral dose of fosinopril reduced mean arterial pressure (p < 0.001) as a result of a 24% fall in total peripheral resistance (p < 0.001). Short-term therapy (12 weeks) maintained the decrease in mean arterial pressure (p < 0.05) by decreasing total peripheral resistance (p < 0.01), without reflexive cardiac stimulation or expanding intravascular volume. Renal vascular resistance decreased (p < 0.05) while renal blood flow, glomerular filtration rate and filtration fraction remained unchanged. The response pattern to mental, isometric and orthostatic stress was similarly unchanged. Left ventricular mass diminished by 11% (p < 0.01); myocardial contractility was unaffected. Afterload was reduced (p < 0.05), and velocity of circumferential fiber shortening and stroke volume increased (p < 0.05). Thus, arterial pressure reduction produced by fosinopril was associated with improved systemic and renal hemodynamics and reduced left ventricular mass.