Objective　To compare the effects of early and long-term treatment with captopril on clinical outcome between elder patients (65-75 years old) and younger patients (＜ 64 years old) suffering from acute myocardial infarction (AMI). 　Methods　In a randomized trial, 822 patients with a first AMI were treated with captopril at initial dosage of 6.25 mg and adjusted to 25 mg t.i.d according to blood pressure (209 younger patients, 269 elder patients) and conventional treatment (131 younger patients, 213 elder patients). Survival rate of the four groups was calculated with Kaplan-Meier method. 　Results　The survival of treatment group was correlated significantly with age during hospitalization (P=0.0002). Eight patients in younger treatment group and 10 patients in younger control group (3.83% vs 7.63%, P＞0.05), 25 patients in elder treatment group and 52 patients in elder control group (9.29% vs 24.41%, relative risk = 0.37, 95% CI 0.29-0.48, P＜0.0001) were died. During follow-up period, the survival was however not related to the age (P＞0.05), and both the elder and younger patients had better survival (all P＜0.01 ) and lower cardiac events (all P＜0.01) during captopril treatment. 　Conclusions　 Captopril exerts less effect on the younger patients but more effect on the elder patients during hospitalization after AMI. Long-term captopril had no difference between the youngers and the elders in prognosis.

Objective To compare the effects of early and long term treatment with captopril on clinical outcome between elder patients (65 75 years old) and younger patients (0 05), 25 patients in elder treatment group and 52 patients in elder control group (9 29% vs 24 41%, relative risk = 0 37, 95% CI 0 29 0 48, P 0 05), and both the elder and younger patients had better survival (all P

AIM:Effects of anatotensin Ⅱ on type Ⅰ collagen synthesis and its mRNA expansion in cultured vascular adventitial fibroblasts. METHODS: Vascular adventitial fibroblasts (VAF)were isolated, cultured from rat thoracic aorta by explant method. ELISA was used to study type Ⅰ collagen synthesis and competihve RT - PCR was employed to detect its mRNA expression after angiotensin Ⅱ administration. RESULTS: Angiontensin Ⅱ caused a dose dependent increase of type Ⅰ collagen synthesis and its mRN expression in VAF. CONCLUSION: The results support that angiotensin Ⅱ is an important factor controlling collagen metabolism of VAF and VAF may play an im- portant role in vascular remodelling of hypertension.

Objectives To assess the effects of long-term angiotensin-converting enzyme(ACE) inhibitor treatment with captopril on cardiac function in acute myocardial infarction (AMI).Methods One hundred and one patients with AMIwho were admitted to hospital within 72 hours of the onset of symptoms with no cardiogenic shock were randomly allocated to captopril (n=52; group Ⅰ) and conventional treatment (n=49; group Ⅱ). Left ventricular (LV) systolic performance and diastolic transmitral flow velocity profiles were assessed by Doppler echocardiography at admission (1.2±1.1 days), before discharge (27±10 days) and during follow-up (363±31 days).Results At one year follow-up, in group Ⅰ LV end-diastolic volume decreased, and ejection fraction increased due to a disproportionate decrease in end-systolic volume. The incidence of cardiac dilatation was reduced. LV early diastolic filling velocity (E)increased and late atrial filling velocity (A) decreased, resulting in an elevation of E/A ratio.However, the mean values of LV systolic and diastolic functional parameters were unchanged in group Ⅱ.Conclusions Long-term treatment with captopril exerts a beneficial effect on cardiac protection for patients with AMI.

Aim:To compare the effect of cilazapril and metoprolol on the compliance o f brachial artery in essential hypertension(EH). Methods:Compliance of brachial artery was determined by Pulsed Doppl er techniques. Brachial artery diameter(Dd),flow velocity(Vm),volumic blood flow (Q) and the distensibility(Dis) increased markedly,the resistance(R) used as the indexes of compliance of brachial artery. Results:Sixty seven EH were divided into two groups(A,B) random ly. Group A were treated with Cilazaril,Group B with Metoprolol. Aft er 6 months treatment, BP in all the patients decreased. In Group A,the Dd,Vm,Q and Dis increased markedly,but R of brachial artery decreased obviously. In group B,no obvious changes of branchial artery were found. Conclusion:Cilazapril may improve the compliance of brachial artery partially.

Abstract:Objective To analyse the relationship between age and treatment with captopril after acute myocardial infarction (AMI).Methods In a randomized trial, 822 patients with a first AMI received conventional medical treatment, including intravenous thrombolytic therapy and oral aspirin or metoprolol, and then were randomly allocated to captopril [dosage from the first 6.25?mg to 25?mg/t.i.d, 209 younger patients (≤64 years), 269 elderly patients (65-75 years)] or conventional treatment only (131 younger patients, 213 elderly). Survival in the four groups was calculated with the Kaplan-Meier method. Multivariate analysis was performed to understand the degree that multi-variables (including age) affect survival in patients taking captopril in the hospital or during long term follow-up.Results The survival of patients who took captopril correlated significantly with age (P<0.001). The survival of the elderly patients on captopril treatment did increase (P<0.0001), but not of the younger ones (P>0.05) during hospitalization. During follow-up, the survival of patients who took captopril correlated insignificantly with age (P>0.05), but both the elderly and the younger patients have good survival rates (all P<0.01) and lower cardiac events (all P<0.01) when they took captopril.Conclusions Captopril exerts a weak effect on the younger patients but a beneficial effect on the elderly patients during hospitalization after AMI. However, there is no difference between the younger and the elderly in the prognosis, both having good survival and lower cardiac events when they take captopril long term during follow-up.