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Beta-blockers vs. angiotensin-converting enzyme inhibitors in hypertension: effects on left ventricular hypertrophy.
J Cardiovasc Pharmacol. 1990; 16 Suppl 5:S145-50.JC

Abstract

Both beta-blockers and angiotensin-converting enzyme (ACE) inhibitors have been shown to cause left ventricular hypertrophy regression in hypertensive patients. So far, no study allowed a true comparison of these drugs in this regard. Therefore, 56 hypertensive patients (38 newly recognized and 18 without any antihypertensive drugs for more than 2 months, mean of 9.5+/-14 months) were randomized to enalapril (En, n = 30) or a beta-blocker, bisoprolol (Bi, n = 26), once daily and underwent before and after 2 and 6 months on treatment (a) office and 24-h ambulatory monitoring of BP, (b) M-mode echo assessment of left ventricular mass (LVM) index and fractional shortening (FS), and (c) Doppler evaluation of left ventricular filling. All recordings were read blindly by two observers. The intraobserver coefficient of variation of LVM was 9%. After 6 months, office BP (146+/-18/90+/-10 vs. 170+/-14/104+/-8 mm Hg) and 24-h BP(120+/-17/77+/-9 vs. 138+/-15/90+/-9 mm Hg) were similarly reduced with both drugs. The LVM index was significantly reduced (p < 0.001) (Bi, 11%; En, 7%) and FS was unchanged. The early to late diastolic left ventricular flow ratio (E/A) was increased with bisoprolol (1.06+/-0.29 vs. 0.85+/-0.17, p < 0.0001) but not with enalapril (0.95+/-0.24 vs. 0.88+/-0.34), but this was mainly due to heart rate reduction with bisoprolol. We found no correlation between the reductions in 24-h BP and in LVM index. Bisoprolol and enalapril were similarly effective in lowering blood pressure (BP) in the office and during 24-h monitoring and in reducing the left ventricular mass index in hypertensive patients.

Authors+Show Affiliations

Hôpital Cardiologique du Haut-Lévêque, Centre Hospitalier Régional de Bordeaux, Pessac, France.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11527119

Citation

Gosse, P, et al. "Beta-blockers Vs. Angiotensin-converting Enzyme Inhibitors in Hypertension: Effects On Left Ventricular Hypertrophy." Journal of Cardiovascular Pharmacology, vol. 16 Suppl 5, 1990, pp. S145-50.
Gosse P, Roudaut R, Herrero G, et al. Beta-blockers vs. angiotensin-converting enzyme inhibitors in hypertension: effects on left ventricular hypertrophy. J Cardiovasc Pharmacol. 1990;16 Suppl 5:S145-50.
Gosse, P., Roudaut, R., Herrero, G., & Dallocchio, M. (1990). Beta-blockers vs. angiotensin-converting enzyme inhibitors in hypertension: effects on left ventricular hypertrophy. Journal of Cardiovascular Pharmacology, 16 Suppl 5, S145-50.
Gosse P, et al. Beta-blockers Vs. Angiotensin-converting Enzyme Inhibitors in Hypertension: Effects On Left Ventricular Hypertrophy. J Cardiovasc Pharmacol. 1990;16 Suppl 5:S145-50. PubMed PMID: 11527119.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Beta-blockers vs. angiotensin-converting enzyme inhibitors in hypertension: effects on left ventricular hypertrophy. AU - Gosse,P, AU - Roudaut,R, AU - Herrero,G, AU - Dallocchio,M, PY - 1990/1/1/pubmed PY - 2001/9/28/medline PY - 1990/1/1/entrez SP - S145 EP - 50 JF - Journal of cardiovascular pharmacology JO - J Cardiovasc Pharmacol VL - 16 Suppl 5 N2 - Both beta-blockers and angiotensin-converting enzyme (ACE) inhibitors have been shown to cause left ventricular hypertrophy regression in hypertensive patients. So far, no study allowed a true comparison of these drugs in this regard. Therefore, 56 hypertensive patients (38 newly recognized and 18 without any antihypertensive drugs for more than 2 months, mean of 9.5+/-14 months) were randomized to enalapril (En, n = 30) or a beta-blocker, bisoprolol (Bi, n = 26), once daily and underwent before and after 2 and 6 months on treatment (a) office and 24-h ambulatory monitoring of BP, (b) M-mode echo assessment of left ventricular mass (LVM) index and fractional shortening (FS), and (c) Doppler evaluation of left ventricular filling. All recordings were read blindly by two observers. The intraobserver coefficient of variation of LVM was 9%. After 6 months, office BP (146+/-18/90+/-10 vs. 170+/-14/104+/-8 mm Hg) and 24-h BP(120+/-17/77+/-9 vs. 138+/-15/90+/-9 mm Hg) were similarly reduced with both drugs. The LVM index was significantly reduced (p < 0.001) (Bi, 11%; En, 7%) and FS was unchanged. The early to late diastolic left ventricular flow ratio (E/A) was increased with bisoprolol (1.06+/-0.29 vs. 0.85+/-0.17, p < 0.0001) but not with enalapril (0.95+/-0.24 vs. 0.88+/-0.34), but this was mainly due to heart rate reduction with bisoprolol. We found no correlation between the reductions in 24-h BP and in LVM index. Bisoprolol and enalapril were similarly effective in lowering blood pressure (BP) in the office and during 24-h monitoring and in reducing the left ventricular mass index in hypertensive patients. SN - 0160-2446 UR - https://www.unboundmedicine.com/medline/citation/11527119/Beta_blockers_vs__angiotensin_converting_enzyme_inhibitors_in_hypertension:_effects_on_left_ventricular_hypertrophy_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=11527119.ui DB - PRIME DP - Unbound Medicine ER -