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Angiotensin II antagonism and the heart: valsartan in left ventricular hypertrophy
1Institute of Clinical Pharmacology, University Witten/Herdecke, Wuppertal, Germany.
Insights
Valsartan significantly reduced left ventricular hypertrophy (LVH) in patients with essential hypertension. This angiotensin II receptor antagonist offers a therapeutic option for normalizing heart mass in hypertensive individuals.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Left ventricular hypertrophy (LVH) is a significant independent risk factor for cardiovascular morbidity and mortality.
- Normalization of left ventricular mass is a key objective in managing hypertension.
- Essential hypertension requires effective antihypertensive treatments that address cardiac remodeling.
Purpose of the Study:
- To compare the efficacy of valsartan, an angiotensin II (AT1-receptor) antagonist, with atenolol, a beta-blocker, in reducing left ventricular mass in patients with essential hypertension and LVH.
- To evaluate the impact of 8-month treatment on blood pressure and left ventricular mass index.
Main Methods:
- A randomized, double-blind study involving 69 previously untreated patients with essential hypertension and LVH.
- Patients received either valsartan (80-160 mg q.d.) or atenolol (50-100 mg q.d.) for 8 months, with some receiving hydrochlorothiazide (HCTZ) as add-on therapy.
- Echocardiography was used to assess left ventricular mass index in 58 patients.
Main Results:
- Both valsartan and atenolol significantly reduced blood pressure in hypertensive patients.
- Valsartan treatment led to a greater reduction in left ventricular mass index (from 127 to 106 g/m2) compared to atenolol (from 127 to 117 g/m2).
- The reduction in LVH with valsartan was statistically significant.
Conclusions:
- Long-term treatment with valsartan effectively reduces left ventricular hypertrophy in patients with essential hypertension.
- Valsartan demonstrates a significant benefit in normalizing left ventricular mass, a desirable goal in antihypertensive therapy.
- Valsartan represents a valuable therapeutic option for managing hypertensive patients with LVH.
Abstract:
Left ventricular hypertrophy (LVH) represents an independent risk factor for cardiovascular morbidity and mortality, and normalization of left ventricular mass has become a desirable goal of antihypertensive treatment. In a randomized, double-blind study, the angiotensin II (AT1-receptor) antagonist valsartan (Diovan ; 80-160 mg q.d.) was compared with the beta-blocker atenolol (50-100 mg q.d.) over 8 months in previously untreated patients with essential hypertension and LVH. Sixty-nine patients were randomized, of whom 58 were evaluated by echocardiography. After 8 months of treatment in the atenolol group [n = 8 with additional hydrochlorothiazide (HCTZ)], initial blood pressure was reduced from 160/103 to 147/92 mm Hg (p < 0.0001). In the valsartan group (n = 9 with HCTZ), blood pressure decreased from 163/101 to 146/90 mm Hg (p < 0.0001). Left ventricular mass index decreased from 127 to 117 g/m2 in the atenolol group and from 127 to 106 g/m2 in the valsartan group. Long-term treatment with valsartan resulted in a significant reduction of LVH in patients with essential hypertension.