| Efficacy of exercise, losartan, enalapril, atenolol and rilmenidine in subjects with blood pressure hyperreactivity at treadmill stress test and left ventricular hypertrophy. | |
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MedLine Citation:
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PMID: 18946484 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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High levels of activity of the renin-angiotensin system (RAS) and sympathetic nervous system (SNS) are related to left ventricular hypertrophy (LVH). A percentage of subjects with hyperactivity to treadmill stress test show LVH to echocardiogram. This paper aims at evaluating neurohumoral influence over these subjects by comparing drugs that block both the RAS and the SNS. In a 1-year open protocol, 195 normotensive subjects, with hyperactivity to treadmill stress test and LVH, were randomly assigned to supervised physical exercise, rilmenidine 1 mg day(-1), atenolol 50 mg day(-1), enalapril 10 mg day(-1) or losartan 50 mg day(-1). Changes in left ventricular mass index (LVMI), measured by means of echocardiogram, were the primary end point. Changes in systolic blood pressure (SBP) at rest and peak effort were also evaluated. Enalapril significantly brought LVMI down in relation to the basal value (28.2%; n=36) similarly to losartan (26.9%; n=42); P>0.05. However, both were more efficient than physical exercise (2.9%; n=39), rilmenidine (5.1%; n=38) and atenolol (7.2%; n=40); P<0.001. There was no significant difference in SBP reduction at rest and peak effort in groups assigned to atenolol, enalapril and losartan; P>0.05. In such groups, reduction was greater than in groups assigned to physical exercise and rimenidine; P<0.001. In conclusion, drugs that block RAS were more efficient in reducing LVH than physical exercise and drugs that block SNS, and such reduction took place regardless of SBP level reduction at rest and peak effort. |
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Authors:
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A C Avanza; A P Mansur; J A F Ramires |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2008-10-23 |
Journal Detail:
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Title: Journal of human hypertension Volume: 23 ISSN: 1476-5527 ISO Abbreviation: J Hum Hypertens Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-23 Completed Date: 2009-08-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8811625 Medline TA: J Hum Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 259-66 Citation Subset: IM |
Affiliation:
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Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina do Estado de São Paulo, São Paulo, Brazil. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antihypertensive Agents / pharmacology* Atenolol / pharmacology* Blood Pressure / drug effects* Enalapril / pharmacology* Exercise Test / drug effects* Exercise Therapy* Female Humans Hypertrophy, Left Ventricular / physiopathology* Losartan / pharmacology* Male Oxazoles / pharmacology* Renin-Angiotensin System / drug effects* Sympathetic Nervous System / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Oxazoles; 114798-26-4/Losartan; 29122-68-7/Atenolol; 54187-04-1/rilmenidine; 75847-73-3/Enalapril |
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