Document Detail


Effects of valsartan on left ventricular diastolic function in patients with mild or moderate essential hypertension: comparison with enalapril.
MedLine Citation:
PMID:  10658943     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study compares the effects of an AT1 angiotensin II receptor antagonist (valsartan) with those of an ACE inhibitor (enalapril) on left ventricular (LV) diastolic function in patients with mild or moderate essential hypertension and no evidence of LV hypertrophy at echocardiography. METHODS: A total of 24 patients (16 men, mean age 47 +/- 8 years) underwent radionuclide ambulatory monitoring (Vest) of LV function at rest and during upright bicycle exercise testing before and after two 4-week treatment periods with valsartan (80-160 mg/day orally) and enalapril (20-40 mg/day orally) according to a double-blind, crossover randomization scheme. RESULTS: In the overall population no differences between the two treatments were found in LV peak filling rate (PFR) either at rest or at peak exercise. In a subgroup analysis it was found that baseline PFR was normal (= 2.5 EDV/sec) in 12 patients (subgroup A) and impaired (< 2.5 EDV/sec) in the remaining 12 (subgroup B). In both subgroups, valsartan and enalapril induced a significant and comparable reduction of systolic and diastolic blood pressure. In subgroup A, valsartan and enalapril did not induce significant changes in PFR. In subgroup B, valsartan increased PFR both at rest (from 2.0 +/- 0.3 to 2.4 +/- 0.3 EDV/sec, P < 0.01) and at peak exercise (from 4.1 +/- 1.1 to 4.4 +/- 1.0 EDV/s, P < 0.05), whereas enalapril did not change PFR either at rest (2.0 +/- 0.4 EDV/s, P < 0.01 versus valsartan) or at peak exercise (3.7 +/- 1.1 EDV/sec, P < 0.05 versus valsartan). CONCLUSIONS: Valsartan-induced renin-angiotensin system blockade is able to improve LV filling in patients with mild or moderate essential hypertension and impaired diastolic function. These findings support the hypothesis of a contribution of the renin-angiotensin system in the control of LV diastolic function in these patients.
Authors:
A Cuocolo; G Storto; R Izzo; G L Iovino; M Damiano; F Bertocchi; J Mann; B Trimarco
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of hypertension     Volume:  17     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-02-29     Completed Date:  2000-02-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1759-66     Citation Subset:  IM    
Affiliation:
Nuclear Medicine Center of the National Council of Research, Department of Biomorphological and Functional Sciences, University Federico II, Napoli, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiography
Antihypertensive Agents / administration & dosage*
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Cross-Over Studies
Double-Blind Method
Enalapril / administration & dosage*
Exercise Test
Female
Heart Rate
Humans
Hypertension / drug therapy*,  radionuclide imaging
Male
Middle Aged
Renin-Angiotensin System / drug effects,  physiology
Tetrazoles / administration & dosage*
Valine / administration & dosage,  analogs & derivatives*
Ventricular Function, Left / drug effects*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine; 75847-73-3/Enalapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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