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Beta-blockers vs. angiotensin-converting enzyme inhibitors in hypertension: effects on left ventricular hypertrophy

P Gosse1, R Roudaut, G Herrero

  • 1Hôpital Cardiologique du Haut-Lévêque, Centre Hospitalier Régional de Bordeaux, Pessac, France.

Journal of Cardiovascular Pharmacology
|January 1, 1990
PubMed

Insights

Beta-blockers and ACE inhibitors effectively lower blood pressure and reduce left ventricular mass in hypertensive patients. This study found both bisoprolol and enalapril equally effective in reducing blood pressure and left ventricular mass index.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Hypertension is a significant risk factor for cardiovascular disease.
  • Left ventricular hypertrophy (LVH) is a common adaptation to hypertension.
  • Beta-blockers and ACE inhibitors are known to cause LVH regression, but direct comparisons are limited.

Purpose of the Study:

  • To compare the efficacy of bisoprolol (a beta-blocker) and enalapril (an ACE inhibitor) in reducing blood pressure and left ventricular mass index in hypertensive patients.
  • To assess the impact of these drugs on left ventricular filling dynamics.

Main Methods:

  • A randomized study involving 56 hypertensive patients.
  • Patients were randomized to receive either bisoprolol or enalapril once daily.
  • Assessments included office and 24-h ambulatory blood pressure monitoring, M-mode echocardiography for left ventricular mass index and fractional shortening, and Doppler evaluation of left ventricular filling at baseline and after 6 months.

Main Results:

  • Both bisoprolol and enalapril significantly reduced office and 24-h blood pressure.
  • Both drugs significantly reduced left ventricular mass index (11% with bisoprolol, 7% with enalapril).
  • Fractional shortening remained unchanged; early to late diastolic left ventricular flow ratio increased with bisoprolol, primarily due to heart rate reduction.

Conclusions:

  • Bisoprolol and enalapril demonstrate similar efficacy in lowering blood pressure and reducing left ventricular mass index in hypertensive patients.
  • No correlation was found between blood pressure reduction and left ventricular mass index reduction.
  • Both drug classes are effective in managing hypertensive cardiac remodeling.

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