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Effects of losartan and valsartan on left ventricular hypertrophy and function in essential hypertension

Maurizio Picca1, Francesco Agozzino, Giancarlo Pelosi

  • 1Division of Internal Medicine, Azienda Ospedaliera Fatebenefratelli and Oftalmico, Macedonio Melloni General Hospital, Milan, Italy.

Advances in Therapy
|August 18, 2004
PubMed

Insights

Valsartan more effectively reduces left ventricular mass (LVM) in hypertensive patients with concentric left ventricular hypertrophy (LVH) compared to losartan. This leads to improved systolic performance and diastolic function.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Research

Background:

  • Essential hypertension is a common condition often associated with left ventricular hypertrophy (LVH).
  • Concentric LVH, a thickening of the left ventricle, can impair cardiac function.
  • Angiotensin II receptor blockers (ARBs) like losartan and valsartan are used to treat hypertension and its cardiac consequences.

Purpose of the Study:

  • To compare the efficacy of valsartan versus losartan in reducing left ventricular mass (LVM) and improving function.
  • To assess the impact of these ARBs on echocardiographic parameters in patients with untreated essential hypertension and concentric LVH.

Main Methods:

  • A double-blind, randomized study involving 30 patients with essential hypertension and concentric LVH.
  • Patients received either losartan (50-100 mg/d) or valsartan (80-160 mg/d).
  • Doppler echocardiograms were performed before treatment, at blood pressure control, and after 6 months.

Main Results:

  • Both losartan and valsartan significantly reduced LVM index (P<.01).
  • Valsartan demonstrated a significantly greater reduction in LVM index compared to losartan (P<.05).
  • Both drugs improved midwall fractional shortening (systolic function) and the early peak/peak atrial velocity ratio (diastolic function).

Conclusions:

  • Valsartan is more effective than losartan in reducing LVM index in hypertensive patients with concentric LVH.
  • The reduction in LVM by valsartan is associated with enhanced midwall systolic performance and improved left ventricular diastolic function.

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