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Effects of the Antihypertensive Fixed-Dose Combinations on an Early Marker of Hypertensive Cardiac Damage in Subjects

A Mazza1, L Schiavon2, M Zuin3

  • 1Hypertension Centre certified by the Italian Society of Hypertension, Azienda ULSS 18 Rovigo, Rovigo, Italy; mazza.alberto@azisanrovigo.it.

American Journal of Hypertension
|April 8, 2016
PubMed

Insights

Fixed-dose combinations of angiotensin II receptor blockers (ARB) + calcium channel blockers (CCB) and angiotensin-converting enzyme inhibitor (ACEI) + CCB effectively reverse left ventricular diastolic dysfunction (LVDD) in hypertensive patients. ACEI + CCB showed superior results in patients with impaired fasting glucose.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Diastolic Dysfunction

Background:

  • Isolated left ventricular diastolic dysfunction (LVDD) is an early indicator of cardiac damage in hypertensive subjects (HTs).
  • Few intervention trials have explored antihypertensive therapies for LVDD regression.
  • This study evaluates fixed-dose combination antihypertensives for BP lowering and LVDD regression in untreated HTs.

Purpose of the Study:

  • To investigate the efficacy of various fixed-dose combination antihypertensive drugs in treating isolated LVDD.
  • To assess the impact of these combinations on blood pressure reduction and LVDD regression.
  • To identify the most effective combination for LVDD regression, particularly in hypertensive patients with impaired fasting glucose.

Main Methods:

  • 168 untreated hypertensive subjects with isolated LVDD were randomized into five treatment groups.
  • Treatments included beta-blocker + diuretic, ACEI + diuretic, ARB + diuretic, ARB + CCB, and ACEI + CCB.
  • Blood pressure was measured at baseline and follow-up; LVDD regression was defined by normalization of E/A and E/E' ratios.

Main Results:

  • Blood pressure reduction was comparable across all treatment groups.
  • LVDD regression was significantly higher in the ARB + CCB and ACEI + CCB groups compared to others.
  • In hypertensive subjects with impaired fasting glucose, ACEI + CCB demonstrated the highest prevalence of LVDD regression (46%).

Conclusions:

  • Fixed-dose combinations of ARB + CCB and ACEI + CCB promote regression of isolated LVDD, independent of blood pressure reduction.
  • The ACEI + CCB combination was particularly effective in hypertensive patients with impaired fasting glucose.
  • These findings highlight specific combination therapies for improving diastolic function in hypertensive patients.
Abstract

Keywords:
antihypertensive drugsblood pressurediastolic dysfunctionfixed-dose combinationhypertension.

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