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Effects of losartan on left ventricular mass: a three-year follow-up in elderly hypertensives with myocardial hypertrophy despite successful conventional antihypertensive treatment.
Moroni, C; Tolone, S; Lopreiato, F; Scrofani, A R; Bossini, A; Affricano, C; Cassone, R; Gaudio, C.
Afiliación
  • Moroni C; Cardiovascular Sciences Department, Medical Therapy Institute, Statistical Department; "Sapienza" University, Rome, Italy. carlo.moroni@uniroma1.it.
Eur Rev Med Pharmacol Sci ; 21(6): 1323-1328, 2017 03.
Article en En | MEDLINE | ID: mdl-28387895
OBJECTIVE: Reversal of left ventricular hypertrophy (LVH) in hypertensive patients appears to be a desirable goal to the reduction cardiac risk. The Renin-Angiotensin System (RAS) seems to play a major role in the establishment and maintenance of LVH through the activated systemic RAS and the Intracardiac Angiotensin System (IAS). We focused on the effects of a three-year treatment with losartan supplement in hypertensive patients with LVH not responding to eight years of an effective previous antihypertensive pharmacological treatment. PATIENTS AND METHODS: Two groups of 28 sex-, age- and therapy-matched subjects with essential hypertension and LVH were taken into consideration. The two groups were in effective pharmacological treatment (BP < 140/90) for eight years previous to their enrollment. Patients of Group A were treated for three years with a losartan (100 mg/die) on-top treatment, whereas patients of Group B continued the follow-up of the previous conventional therapy. Both groups were submitted to an echocardiographic follow-up. RESULTS: Group A, showed a significant reduction of the mean LVH since the first step at six months with a further significant trend during the whole period (variance analysis: p < 0.001). Group B showed a non-significant trend toward LVH reduction during the three-year follow-up. No significant further reduction of systolic or diastolic blood pressure values was observed in both groups. CONCLUSIONS: The effects of losartan in hypertensive and hypertrophic patients are in agreement with the results of LIFE Trial. However, the reduction of left ventricular hypertrophy in our patients seems to be related to changes inducted by losartan on the IAS, since no further hemodynamic effects were observed. Losartan induced both a significant reduction of LVH and an improvement of LV diastolic function with a subsequent expected beneficial shift on the prognosis.
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Bases de datos: MEDLINE Asunto principal: Hipertrofia Ventricular Izquierda / Losartán / Hipertensión / Antihipertensivos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Eur Rev Med Pharmacol Sci Asunto de la revista: FARMACOLOGIA / TOXICOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Italia
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Bases de datos: MEDLINE Asunto principal: Hipertrofia Ventricular Izquierda / Losartán / Hipertensión / Antihipertensivos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Eur Rev Med Pharmacol Sci Asunto de la revista: FARMACOLOGIA / TOXICOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Italia