COMPARISON OF THE EFFECTS OF NITRENDIPINE AND CAPTOPRIL ON THE REGRESSION OF HYPERTENSIVE LEFT-VENTRICULAR HYPERTROPHY

To compare the efficacy of new calcium blocker nitrendipine and ACE-inhibitor captopril on the regression of hypertensive left ventricular hypertrophy (LVH), 134 hypertensive subjects with LVH were divided randomly into two groups. 2DE, M-mode and pulsed Doppler echocardiography was used to measure the left ventricular structure and function. In the nitrendipine group (n = 67, mean age 48 +/- 11 years), nitrendipine (20-40 mg / day) was administered for 24 months, and in the captopril group (n = 67, mean age 47 +/- 12 years), captopril (75-150 mg / day) was also given for 24 months. Blood pressure decreased significantly in all the patients. In the nitrendipine group, the thickness of the interventricular septum (IVST) and the posterior wall of the left ventricle (PWT) as well as the left ventricular mass index (LVMI) decreased by 20.3%, 15.5% and 25.7% (P < 0.01) respectively. The cardiac index (CI), left ventricular ejection fraction (EF) and fractional shortening (FS) remained unchanged. The early peak filling velocity (E, 0.64 +/- 0.15 to 0.86 +/- 0.22, P < 0.01) of the mitral valve and E to late peak filling velocity ratio (E / A, 0.88 +/- 0.20 to 1.31 +/- 0.31, P < 0.01) increased significantly. In the captopril group, IVST, PWT, and LVMI were 20%, 17.1% and 23.6% respectively (P < 0.01). CI (2.6 +/- 0.5 to 3.7 +/- 0.6L / min / m, P < 0.01) and EF (60 +/- 4 to 78 +/- 6%, P < 0.01) increased. Both E and E / A were elevated in a similar degree as in the nitrendipine group. The calcium channel blocker nitrendipine and ACE-inhibitor captopril are equipotent in bringing regression of hypertensive LVH and improving diastolic function. Captopril enhances left ventricular pumping function with reversal of LVH.