EFFECT OF PERINDOPRIL AND METOPROLOL ON LEFT-VENTRICULAR HYPERTROPHY AND PERFORMANCE IN ESSENTIAL-HYPERTENSION

The effects of perindopril and metoprolol on left ventricular hypertro phy (LVH) and function were studied in 47 essential hypertensive patie nts with LVH. Previous antihypertensive drugs were discontinued for at least 2 weeks, after which patients were randomly divided into 2 grou ps. 25 subjects were treated with perindopril 4 to 8 mg once daily in the morning (Group A) and 22 subjects with metoprolol 25 to 62.5 mg tw ice daily (Group B). The subjects were evaluated before and after 4 an d 8 weeks of treatment by use of echocardiography. Before treatment LV mass indexes (LVMI) of two groups were respectively 143.2 +/- 21.3 g/ m(2) and 140.6 +/- 23.7 g/m(2) (P>0.05). In Group A, reduction of LVMI occurred after 4 weeks of treatment, and more pronounced after 8 week s (from 143.2 +/- 21.3 g/m(2) to 126.6 +/- 15.3 g/m(2), P<0.001), wher eas reduction of LVMI occurred only after 8 weeks in Group B (from 140 .6 +/- 23.7 g/m(2) to 133.4 +/- 13.2 P<0.001). In addition, there was a significant (P<0.05) difference in LVMI between the two groups after 8 weeks. LV systolic function remained unchanged, whereas E/A increas ed significantly (P<0.001) in two groups after 8 weeks In conclusion, antihypertensive treatment with perindopril and metoprolol induced a s ignificant regression of LVH associated with improvement in LV diastol ic performance. Perindopril, compared with metoprolol, was more effect ive in reversing LVH.