Effect of long-term eprosartan versus enalapril antihypertensive therapy on left ventricular mass and coronary flow reserve in stage I-II hypertension

A double-blind comparator study was performed in 528 hypertensive patients [baseline sitting diastolic blood pressure (SitDBP) 95-114 mmHg]. The prima ry objective was to compare the incidence of drug-related cough in patients treated with enalapril and eprosartan. This paper reports the results of 2 7 asymptomatic patients who were recruited into a single centre substudy of the multicentre trial and randomised to receive either eprosartan (200-300 mg b.i.d.) or enalapril (5-20 mg o.d.). Blood pressure (BP) reduction, lef t ventricular (LV) mass regression and change in coronary flow reserve (CFR ) after 6 months' treatment with either eprosartan or enalapril were compar ed. At the end of the study eprosartan and enalapril were found to have cau sed similar reductions in BP. There was an increase in CFR in the eprosarta n group to 1.6 +/- 0.3 and a decrease in CFR in the enalapril group to 1.3 +/- 0.3. Neither value was significantly different from baseline although t he difference between the two groups was significant (p = 0.05). By study e ndpoint, there was a significant reduction in LV mass in the enalapril grou p (p = 0.05), but not the eprosartan (p = ns) group. Further investigation of the effects of angiotensin receptor blockers on CFR and LV mass regressi on appear warranted.