3. Losartan and Enalapril in the Treatment of Essentail Hypertension — Effect on LeftVentricular Mass and Function

Abstract

Background: The aim of the study was to assess the effect of losartan and enalapril on arterial blood pressure and left ventricular mass and selected parameters of its function in patients with hypertension.

Material and methods Examinations were performed in 61 subjects (43 men and 18 women) aged 37–70 years (mean 56,8 ± 8). Losartan was applied in 31 subjects in a dose 50 mg/24 h, while enalapril in 30 subjects in a dose 10–20 mg/24 h for 12 months. 17 subjects on losartan and 18 on enalapril had left ventricular hypertrophy. Arterial pressure measurements and echocardiography were performed before and after 1, 3, 9 and 12 months of treatment.

Results: In the initial period of the therapy greater hypotensive effect was observed in the group of patients without ventricular hypertrophy; after 3 months losartan and enalapril hypotensive effect was similar in subjects with and without ventricular hypertrophy. Left ventricular mass index decreased, ejection fraction increased after 3–6 months of losartan and enalapril therapy, while early to atrial peak flow velocity ratio (E/A) increased after 1–3 months of the therapy. Analysis of the changes of echocardiographic parameters values showed that left ventricular mass index decreased only in the group of patients with left ventricular hypertrophy.

Conclusion: Losartan and enalapril demonstrate similar hypotensive effect and similar effect on left ventricular mass and function in subjects with essential hypertension.