[Effect of verapamil and nitrendipine on the left ventricular mass and function (systolic and diastolic) in arterial hypertension]. / Efecto de verapamilo y nitrendipino sobre la masa y función (sistólica y diasólica) ventricular izquierda en la hipertensión arterial.

ABSTRACT

BACKGROUND: To evaluate the effect of two calcium antagonists (verapamil and nitrendipine) on the regression of left ventricular mass and function (systolic and diastolic) by echocardiography-Doppler, in not treated hypertensive subjects. METHODS: 31 hypertensive subjects were studied in a randomized, placebo controlled, prospective and double blind trial. Verapamil (120-240 mg/day) was administered in 16 and nitrendipine (10-20 mg/day) in 15. The active drug therapy phase was 12 months with rest and effort tensional evaluation. Echo-Doppler was performed in the placebo phase, 6 and 12 months, evaluating left ventricular structure (septal and posterior-wall thicknesses, diameters and mass) and function (systolic and diastolic). RESULTS: Tensional control at rest and under effort was similar with both drugs, heart rate decreased only with verapamil. Left ventricular mass index decreased with verapamil and nitrendipine, due to reduction in the wall thicknesses (with verapamil from 158.5 +/- 31 to 135.7 +/- 20 g/m2 and with nitrendipine from 167.3 +/- 26 to 146.9 +/- 21 g/m2, p < 0.05). Left ventricular systolic function was not modified during the follow-up with both drugs. Only in the verapamil group some left ventricular diastolic function parameters improved (E from 0.82 +/- 0.11 to 0.95 +/- 0.14 and E/A/Age from 0.013 +/- 0.005 to 0.017 +/- 0.005; p < 0.05). CONCLUSIONS: Verapamil and nitrendipine exerts a similar tensional control at rest and under effort and left ventricular mass regression. The improvement of some diastolic function parameters in the verapamil group was probably due to bradycardia.