Regression of left ventricular mass in hypertensive patients treated with perindopril/indapamide as a first-line combination: the REASON echocardiography study.

Abstract

BACKGROUND:

Increase in left ventricular mass (LVM) may be linked to morbidity and mortality in hypertensive patients. Arterial stiffness, systolic blood pressure (BP), and pulse pressure (PP) seem to be the main determinants of LVM. The perindopril/indapamide combination normalizes systolic BP, PP, and arterial function to a greater extent than atenolol. The aim of this study was to compare the effects of perindopril (2 mg)/indapamide (0.625 mg) first-line combination with atenolol (50 mg) on LVM reduction in hypertensive patients.

METHODS:

Two hundred fourteen patients with essential hypertension participating in the PREterax in Regression of Arterial Stiffness in a ContrOlled Double-BliNd (REASON), randomized, double-blind, parallel-group study, underwent M-mode two-dimensional-guided echocardiography.

RESULTS:

Perindopril/indapamide and atenolol were both effective at brachial BP reduction during the 12-month period. The systolic BP reduction was significantly greater with perindopril/indapamide than with atenolol (-21.2 v -15.3 mm Hg), whereas the reduction in diastolic BP was similar between treatment groups (-12.1 v -11.3 mm Hg). Reduction in LVM was higher with perindopril/indapamide than with atenolol. The between-group difference was significant for LVM (-13.6 v -4.3 g, P = .027), LVM/body surface area (LVMI1, P = .032), and LVM/body height2.7 (LVMI2, P = .013). The 124 patients with LV hypertrophy at baseline showed greatest LVM regression (LVM: -22.5 v -8.9 g, P = .009; LVMI1, P = .031; LVMI2, P = .028). The reduction in LVM adjusted for brachial systolic BP and heart rate was still significantly greater with perindopril/indapamide than with atenolol.

CONCLUSIONS:

Treatment, based on a first-line perindopril/indapamide combination in hypertensive patients, was more effective than atenolol on regression of echocardiographic indices of LVM and LV hypertrophy.

• Authors: Nicola de Luca, Jean-Michel Mallion, Michael F O'Rourke, Eoin O'Brien, Karl-Heinz Rahn, Bruno Trimarco, Ramon Romero, Peter Wilhelmus De Leeuw, Gerhart Hitzenberger, Edouard Battegay, Daniel Duprez, Peter Sever, Michel E Safar
• Journal: American journal of hypertension (Am J Hypertens) Vol. 17 Issue 8 Pg. 660-7 (Aug 2004) ISSN: 0895-7061 [Print] United States
• PMID: 15323062 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2004 American Journal of Hypertension, Ltd.

Chemical References

• Antihypertensive Agents
• Atenolol
• Indapamide
• Perindopril

Topics

• Adult
• Aged
• Antihypertensive Agents (administration & dosage, adverse effects)
• Atenolol (administration & dosage)
• Blood Pressure (drug effects)
• Brachial Artery
• Drug Therapy, Combination
• Echocardiography
• Female
• Humans
• Hypertension (diagnostic imaging, drug therapy)
• Hypertrophy, Left Ventricular (diagnostic imaging, drug therapy)
• Indapamide (administration & dosage, adverse effects)
• Male
• Middle Aged
• Perindopril (administration & dosage, adverse effects)