REDUCTION OF LEFT-VENTRICULAR MASS BY SHORT-TERM ANTIHYPERTENSIVE TREATMENT WITH ISRADIPINE - A DOUBLE-BLIND COMPARISON WITH ENALAPRIL

The aim of the present study was to evaluate the effect of dihydropyri dine calcium antagonist isradipine on left ventricular (LV) structure and function in patients with essential hypertension. Cuff blood press ure and Doppler echocardiographic variables were assessed in 26 patien ts with mild to moderate hypertension (diastolic blood pressure range 95-110 mmHg) before and after 12 weeks of therapy with either isradipi ne 5 mg daily or enalapril 20 me daily. The study was of double-blind, parallel design, with a placebo run-in period of 15 days. Three subje cts withdrew from isradipine treatment because of flushing and 2 from enalapril treatment due to cough before completin,o the study. Both dr ugs significantly reduced cuff systolic and diastolic blood pressure ( p < 0.001) without affecting heart rate. By virtue of the decrease in both septal wall (p < 0.01) and posterior wall thicknesses (p < 0.05), isradipine treatment produced a significant reduction in LV mass adju sted for height (p < 0.001) in comparison with placebo; also LV end-sy stolic dimension showed a slight decrease (p < 0.05). Enalapril induce d a similar reduction in LV end-systolic dimension (p < 0.05) but the changes of wall thickness and LV mass did not reach statistical signif icance. In conclusion, our results indicate that isradipine treatment improves LV systolic function and causes a significant reduction in LV mass. This reduction is observed early in the course of antihypertens ive treatment and is effective in both patients with and without LV hy pertrophy.