LONG-TERM EFFECTS OF LOSARTAN ON BLOOD-PRESSURE AND LEFT-VENTRICULAR STRUCTURE IN ESSENTIAL-HYPERTENSION

In a 12-week, randomized, double-blind study, 24 patients with essenti al hypertension were given the angiotensin II antagonist losartan, or the beta-adrenoceptor blocker atenolol. Both drugs reduced blood press ure (BP) well, but losartan tended to reduce left ventricular mass (LV M) in contrast to atenolol. Following the double-blind phase 19 patien ts entered an open treatment period with losartan and additional treat ment if BP was uncontrolled. LV structures were measured by echocardio graphy. The mean follow-up period was 29 +/- 2.6 (range 26-32) months. BP was reduced from 155.6 +/- 15.6/103.4 +/- 5.2 mm Hg to 131.3 +/- 1 0.5/32.7 +/- 3.3 mm Hg (P < 0.001). LV internal diameter was reduced ( 50.7 +/- 4.5 to 49.1 +/- 4.0 mm; P = 0.006), while there was an increa se in interventricular septal thickness (10.2 +/- 1.1 to 11.2 +/- 1.3 mm; P = 0.001) and posterior wall thickness (10.0 +/- 0.9 to 10.6 +/- 1.1 mm; P = 0.023). Calculated LVM was not significantly altered durin g the follow-up period. In conclusion, losartan is effective in reduci ng BP during long-term treatment. No significant effect on LVM was obs erved, but there was an increase in LV wall thickness.