Comparison of the effects of an ACE inhibitor and alpha beta blocker on the progression of renal failure with left ventricular hypertrophy: Preliminary report

The aim of this study was to compare the effects of an angiotensin-converti ng enzyme (ACE) inhibitor and alpha beta blocker in combination with a calc ium antagonist on the progression of renal function and left ventricular hy pertrophy (LVH) in patients with chronic renal insufficiency and hypertensi on. The 65 subjects in this study were recruited from a cohort of 316 patie nts. The main criteria for inclusion were echocardiographic diagnosis of LV H (posterior wall thickness >12 mm) and serum creatinine of more than 1.5 m g/dl, Antihypertensive treatments were switched to the combination of amlod ipine at a dose of 5 mg and benazepril at a dose of 2.5 mg daily or the com bination of amlodipine at a dose of 5 mg and arotinolol at a dose of 20 mg daily at random irrespective of whether or not patients had been previously treated. The follow-up period was 2 years. Systolic and diastolic blood pr essure were significantly reduced from 150/90+/-15/11 mmHg to 130/75+/-11/9 mmHg (ACE) and the levels of serum creatinine were increased significantly from 1.8+/-0.3 to 2.0+/-0.4 mg/dl (ACE), In the alpha beta -blocker group, these two values were similar and no significant changes were found, PWT w as decreased from 14.2+/-0.6 to 12.9+/-0.3 cm in alpha beta blocker but was not significantly decreased in the ACE inhibitor group. In conclusion, com bination therapy with a calcium antagonist and alpha beta blocker might be effective treatment for hypertensive patients with chronic renal insufficie ncy and left ventricular hypertrophy.