The authors investigated in a one-year multicentric open study the effect of enalapril (Enalapril Lachema-Pliva) in 653 patients with mild to moderate hypertension treated in ambulance of 128 general practitioners and specialists in internal medicine. The blood pressure was checked after 6 weeks during the first six months and every 3 months during the second six months. Normal levels of diastolic pressure were achieved in 576 (82%) patients, whereby a combination of antihypertensive drugs had to be used in 383 (59%) patients. Complete renal functions were assessed in 51 patients, microalbuminuria declined from 91.8+/- 37.8 to 72.1 +/- 13.1 mg/l (p < 0.001), glomerular filtration was not affected. Parameters of insulin sensitivity were assessed in 117 patients, the complete lipid spectrum in 253 patients. IRI declined from 12.29 +/- 5.40 to 11.57 +/- 5.42 (p = 0.06) and glycosylated haemoglobin from 6.98 +/- 2.39 to 6.69 +/- 1.97 (p = 0.03), which slows improved insulin sensitivity. Total-cholesterol, LDL-cholesterol and triglycerides decreased significantly and HDL increased (p < 0.001). The left ventricle mass declined significantly after treatment, using Dewereux's calculation, by 17.2 %. The left ventricular diastolic function was not affected by the treatment, however, the lef aulium and left ventricle diminished in volume.

Keywords: Antihypertensive Agents /therapeutic use/; Blood Pressure /drug effects/; Diabetes Complications; Diabetes Mellitus /physiopathology/; Enalapril /therapeutic use/; Female; Humans; Hypertension /drug therapy/; Male; Middle Aged; Myocardial Ischemia /complications/