Effects of Angiotensin Receptor Blockers Therapy on Left Ventricular Hypertophy and Nt-Probnp Level in Hypertensives

Abstract

Objective: To evaluate the effect of valsartan, eprosartan or losartan on LVH and NT-proBNP levels in patients with hypertension and preserved ejection fraction Design and method: This is randomized, prospective and double-blind study involved 154 hypertensive patients (56,5% men; mean age 53,6 ± 0,5 years) with concentric LVH remodeling (LV mass > 115 g/m2 and 95 g/m2 in men and women, respectively), which were eligible criterions to randomize to receive medication into three groups: valsartan (n = 48), eprosartan (n = 54), losartan (n = 52) over a follow-up period of 24 months. Echocardiography, ambulatory blood pressure monitoring and NT-proBNP assessments were performed at baseline and after 24 months treatment. Results: Despite similar effects on ambulatory blood pressure levels, significant differences on LV mass index were found between valsartan, eprosartan and losartan treatment (mean decrease 27.0 g/m2 vs 35 g/m2 and 24.0 g/m2, respectively, p < 0,001), and there was positive correlation of changes in ambulatory systolic blood pressure with LV mass index (r = 0,5; p < 0,001). Eprosartan-based therapy induced a greater reduction in NT-proBNP levels (-45,6%, p < 0,001) from baseline than in the valsartan (-28,9%, p < 0,01) and losartan group (- 26,5%,, p < 0,01). Conclusions: The findings of this study showed that all three agents progressively reduced LVH, but the reduction was significantly greater in the eprosartan group. Additionally, eprosartan was associated with a greater reduction of NT-proBNP levels.