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Expert Opin Pharmacother. 2012 Jun;13(8):1091-9. doi: 10.1517/14656566.2012.683175. Epub 2012 Apr 20.

Effects of valsartan or ramipril addition to amlodipine/hydrochlorothiazide combination on left ventricular mass in diabetic hypertensive patients with left ventricular hypertrophy.

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1
University of Pavia, Clinica Medica II, Centro Ipertensione e Fisiopatologia Cardiovascolare, Department of Internal Medicine and Therapeutics, Fondazione IRCC Policlinico S. Matteo, Piazzale Golgi 19, 27100 Pavia, Italy. r.fogari@unipv.it

Abstract

OBJECTIVE:

The objective of this study was to compare valsartan or ramipril addition to amlodipine + hydrochlorothiazide (HCTZ) on blood pressure (BP) and left ventricular hypertrophy (LVH) in hypertensive diabetic patients with LVH.

RESEARCH DESIGN AND METHODS:

293 patients were treated with amlodipine 10 mg + HCTZ 12.5 combination and then randomized to receive valsartan 160 mg or ramipril 5 mg, in addition to the previous therapy, for 1 year.

MAIN OUTCOME MEASURES:

Clinic BP was measured every month; echocardiographic assessments were performed at the end of the placebo period, both before the randomization and after 1-year of triple combination therapy.

RESULTS:

Both triple regimens similarly reduced SBP/DBP values (-13.5/10.9 mm Hg in the valsartan group and -13.4/10.4 mm Hg in the ramipril group). Triple combination including valsartan better reduced LVMI (-20.1%, p < 0.001), interventricular septal thickness (IVST) (-20.3%, p < 0.001) and left ventricular posterior wall thickness (PWT) (-16.3%, p < 0.001), compared with triple combination including ramipril (-14%, p < 0.01; -16.2%, p < 0.001 and -9%, p < 0.01, respectively); the difference between treatments being statistically significant (p < 0.05). Triple combination with valsartan gave a greater increase of E/A ratio (p < 0.05 between groups).

CONCLUSIONS:

Valsartan addition to dual therapy with amlodipine + HCTZ was more effective than ramipril addition in reducing LVH.

PMID:
22515416
DOI:
10.1517/14656566.2012.683175
[Indexed for MEDLINE]
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