Effects of renin-angiotensin system inhibition on right ventricular function in patients with mild essential hypertension

Introduction: Systemic hypertension is known to affect both left and right ventricular (RV) function. Little is known about the effect of the renin—angiotensin system (RAS) inhibition on global RV function in patients with essential hypertension.

Materials and methods: Forty patients (17 male, mean age 47 ± 10 years) with mild hypertension free of cardiovascular disease were assessed by echocardiography at baseline and after nine months of antihypertensive treatment with RAS inhibitors. Tissue Doppler imaging derived myocardial performance index (MPI) of the left and right ventricle was used as an index of global ventricular function.

Results: Both left ventricular (LV) and RV MPI were increased at baseline and were reduced after treatment (LV MPI reduced from 0.42 ± 0.06 to 0.39 ± 0.05, p < 0.001 and RV MPI was reduced from 0.34 ± 0.06 to 0.32 ± 0.05, p < 0.005). There was a positive correlation between mitral and tricuspid E/A ratio both at baseline and at month nine after treatment (r = 0.661, p < 0.001 and r = 0.503, p < 0.005 respectively). LV mass index and interventricular septum thickness were decreased after treatment. No correlation was found between MPI improvement and blood pressure reduction.

Conclusions: RAS inhibition in patients with mild hypertension results in an improvement of RV global function which is unrelated to the reduction in blood pressure.