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A comparison study of the echocardiographic changes in hypertensive patients treated with telmisartan vs. enalapril
Najah R Hadi1, Mohammad S Abdulzahra2, Laith M Al-Huseini3
1Department of Pharmacology and Therapeutics, College of Medicine, University of Kufa, Iraq.
Insights
Telmisartan and enalapril both improved diastolic function in hypertensive patients. Telmisartan also significantly reduced left ventricular mass index and septal thickness, offering distinct benefits for cardiac remodeling.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Hypertension significantly impacts cardiac function, with varied responses to different antihypertensive medications.
- Understanding the comparative effects of drugs like telmisartan and enalapril on cardiac structure and function is crucial.
Purpose of the Study:
- To compare the echocardiographic effects of telmisartan versus enalapril in patients with hypertension.
- To evaluate the impact of these antihypertensive agents on left ventricular systolic and diastolic functions, and cardiac mass.
Main Methods:
- A randomized, single-blind study involving 80 hypertensive patients divided into two groups.
- Group 1 received telmisartan 80mg daily; Group 2 received enalapril 20mg daily for six months.
- Echocardiography assessed left ventricular function, mass index, and interventricular septal thickness; blood pressure and heart rate were also monitored.
Main Results:
- Both telmisartan and enalapril significantly improved diastolic functional parameters (P<0.010).
- Neither drug demonstrated significant changes in systolic functional parameters.
- Telmisartan showed a significant reduction in interventricular septal thickness and left ventricular mass index (P<0.010).
Conclusions:
- Both telmisartan and enalapril, by targeting the renin-angiotensin aldosterone system, offer myocardial protection against hypertension.
- Telmisartan demonstrated superior efficacy in reducing cardiac structural parameters, suggesting potential advantages in managing hypertensive cardiac remodeling.
Background:
Hypertension-induced cardiac dysfunction is variable among different anti-hypertensive medications. This study compares the effects of telmisartan and enalapril on echocardiographic parameters in hypertensive patients.
Materials And Methods:
This was a randomised single blinded study. Eighty hypertensive patients were included in this study and they were randomly allocated into two study groups: Group 1 included 40 patients who took telmisartan 80mg once daily for six months. Group 2 included 40 patients who took enalapril, 20mg once daily for six months. An additional 40 healthy participants were enrolled in the study as controls (Group 3). Baseline echocardiographic scan was done at the start of the study and after 6 months of treatment including assessment of left ventricular systolic and diastolic functions with assessment of left ventricular mass index, in addition to measurements of blood pressure, heart rate and double product.
Results:
Both group 1 and group 2 (telmisartan and enalapril groups respectively) showed comparable statistically significant improvement in the diastolic functional parameters (P<0.010), while both medications didn't demonstrate changes in the systolic functional parameters. Furthermore, telmisartan was significantly effective in reducing the interventricular septal thickness and left ventricular mass index (P<0.010).
Conclusions:
Both drugs interfere with renin-angiotensin aldosterone system, protecting the myocardium from high blood pressure. Findings from our study provide key results for physicians in deciding the appropriate antihypertensive drug for each patient depending based on the patient's intolerability for either medication.
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