Influence of different angiotensin receptor blockers-based regimens on left ventricular hypertrophy and NT-proBNP levels in hypertensives with left ventricular diastolic dysfunction

Introduction: Left ventricular hypertrophy (LVH) and diastolic dysfunction represent an „association of in-terests” that lead to development of heart failure (HF). Objective: To compare the effects of different ARBs-based regimens with valsartan, losartan or eprosartan on LVH and NT-proBNP activity in hypertensives with LV diastolic dysfunction.
Methods: 154 hypertensive patients (56.5% of men; mean±SD age 53.6±0.5 yrs; HT-13,2±1,95 months) with concentric LVH remodeling (LV mass >115 g/m2 and 95 g/m2 in men and women, respectively; RWT >0.42) and diastolic dysfunction were randomly assig-ned to treatment with valsartan (V-gr, n=52 patients), losartan (L- gr, n=5 patients), or eprosartan (E-gr, n=51 patients) during 1year. Transthoracic echocardiogra-phy, ambulatory blood pressure monitoring and NT-proBNP assessments were performed at baseline and after 6 and 12 months period.
Results: At baseline, there was no statistical differences between groups with respecte the clinic and haemodyna-mical status. LV remodeling indices have a beneficial evolution in all groups, but more significant (p<0.001) in the E-gr. At baseline, LVMI was 147.42±12.24 g/m2 in V-gr; 147.64±11.14 g/m2 in L-gr and 147.76±10.93 g/m2 in E-gr; after 6 months-142.64±29.85 g/m2 in V-gr; 141.56±19.55 g/m2 in L-gr and139.91±28.18 g/ m2 in E gr, respectively, (p<0.001), after 12 months: 117.09±25.75 g/m2 in V-gr; 116.10±26.35 g/m2 in L-gr and 97.38±22.43 g/m2 (p<0.001), respectively. At the end of study, RWT \’s reduction was statistic authentic (p<0.001) and constituted 0.42±0.04 in V-gr, 0.41±0.01 în V-gr and 0.40±0.02 in E-gr. The NT-proBNP levels have decreased more significantly in the eprosartan group (-45.6%, p<0.001), while in the valsartan and losartan group the reduction was comparable (-28.1% and 27.9%, respectively, p>0.05).
Conclusions: T he findings of this study showed that valsartan, losartand and eprosartan progressively im-prove hypertensive LV geometry and NT-proBNP acti-vity, but with greater efficiency in the Eprosartan-me-dicated arm, probably due to additional sympatholytic effect of its moiety.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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