[Changes in left ventricular function and structure in hypertensive patients treated with methyldopa and urapidil]

Area of Science:

• Cardiology
• Pharmacology
• Hypertension Research

Background:

• Mild-to-moderate hypertension requires effective treatment options.
• Left ventricular hypertrophy (LVH) is a significant complication of hypertension.
• Assessing the impact of antihypertensives on LVH is crucial for patient outcomes.

Purpose of the Study:

• To compare the effects of methyldopa and urapidil on blood pressure and echocardiographic parameters in hypertensive patients.
• To evaluate the efficacy of these drugs in reducing left ventricular hypertrophy (LVH).

Main Methods:

• A randomized, cross-over, double-blind trial involving 20 mild-to-moderate hypertensives.
• Participants received methyldopa (250 mg b.i.d.) or urapidil (30 mg b.i.d.) for 7 weeks, followed by a 1-week wash-out and then the alternative drug for 7 weeks.
• Echocardiography and electrocardiography were used to assess left ventricular structure and function.

Main Results:

• Both methyldopa and urapidil significantly reduced systolic and diastolic arterial pressure (P < 0.01).
• Neither drug significantly altered body weight or heart rate (P > 0.20).
• Methyldopa significantly decreased left ventricular posterior wall thickness (LVPWd) (P < 0.05), while urapidil did not significantly affect LVH parameters (P > 0.05).
• Echocardiography proved more sensitive than electrocardiography in detecting LVH.

Conclusions:

• Methyldopa demonstrated a potential benefit in reducing left ventricular hypertrophy (LVH).
• Direct and indirect vasodilators like urapidil were less effective in reducing LVH compared to methyldopa.
• Both drugs effectively manage blood pressure in mild-to-moderate hypertension.