Effects of valsartan and enalapril on regression of left ventricular hypertrophy in patients with mild to moderate hypertension: A randomized, double-blind study

Objective: This study was undertaken to compare the effects of valsartan wi th those of enalapril on regression of left ventricular hypertrophy in pati ents with mild to moderate hypertension. Background: The effect of angiotensin II receptor antagonists on regression of left ventricular hypertrophy in patients with hypertension has been est ablished in several studies. The effects of these agents have also been com pared with those of other antihypertensive drugs such as diuretics or beta- receptor blocking agents. However, no study has compared angiotensin II rec eptor antagonists with angiotensin-converting-enzyme (ACE) inhibitors. The effect of ACE inhibitors on regression of left ventricular hypertrophy is s uperior to that of other antihypertensive drugs. Methods: Forty patients with mild to moderate hypertension and left ventric ular hypertrophy were included in this randomized, double-blind study. Pati ents were divided into 2 groups. No between-group differences were noted wi th regard to age, systolic and diastolic blood pressures, duration of hyper tension, and left ventricular mass index, which was measured by M-mode echo cardiography. Twenty patients received enalapril 20 mg/d, and 20 patients r eceived valsartan 80 mg/d. Echocardiographic measurements were repeated at 3 and 6 months, and blood pressure was measured every 15 days. Results: Systolic and diastolic blood pressures decreased significantly at 3 and 6 months in both groups (P < 0.001), as did left; ventricular mass in dex (P < 0.02 and P < 0.01, respectively). Cough and fatigue occurred in 3 (15%) and 2 (10%) patients in the enalapril group. No adverse effects were reported in the valsartan group. Conclusions.. In patients with left ventricular hypertrophy caused by hyper tension, valsartan is as effective as enalapril in reducing left ventricula r hypertrophy.