Clinical Trials

European Journal of Clinical Pharmacology

, Volume 61, Issue 5, pp 353-359

Effects of valsartan and perindopril combination therapy on left ventricular hypertrophy and aortic arterial stiffness in patients with essential hypertension

  • Futoshi AnanAffiliated withDepartment of Internal Medicine 1, Faculty of Medicine, Oita UniversityDepartment of Cardiovascular Disease, Oita Red Cross Hospital
  • , Naohiko TakahashiAffiliated withDepartment of Internal Medicine 1, Faculty of Medicine, Oita University Email author 
  • , Tatsuhiko OoieAffiliated withDepartment of Laboratory Medicine, Faculty of Medicine, Oita University
  • , Kunio YufuAffiliated withDepartment of Cardiovascular Disease, Oita Red Cross Hospital
  • , Masahide HaraAffiliated withDepartment of Internal Medicine 1, Faculty of Medicine, Oita University
  • , Mikiko NakagawaAffiliated withDepartment of Laboratory Medicine, Faculty of Medicine, Oita University
  • , Hidetoshi YonemochiAffiliated withDepartment of Laboratory Medicine, Faculty of Medicine, Oita University
  • , Tetsunori SaikawaAffiliated withDepartment of Laboratory Medicine, Faculty of Medicine, Oita University
  • , Hironobu YoshimatsuAffiliated withDepartment of Internal Medicine 1, Faculty of Medicine, Oita University

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Objective

To compare the effects of combined therapy of an angiotensin II receptor blocker (ARB; valsartan) and an angiotensin converting enzyme inhibitor (ACEI; perindopril) on blood pressure (BP), metabolic profiles, plasma brain natriuretic peptide (BNP) levels, echocardiographic findings, and aortic pulse wave velocity (PWV) with those of respective monotherapy in never-treated patients with essential hypertension.

Methods

This was a prospective randomized trial, in which there were 31 patients with essential hypertension and left ventricular hypertrophy (LVH) who visited the outpatient clinic of Oita Red Cross Hospital (14 women and 17 men; mean±SD age, 59±5 years). Each patient was randomly assigned to receive valsartan (160 mg/day, V group, n=10), perindopril (8 mg/day, P group, n=11), or a combination of valsartan (80 mg/day) and perindopril (4 mg/day, V+P group, n=10) for 40 weeks. Ambulatory BP monitoring (ABPM), echocardiographic findings, metabolic findings, plasma BNP levels, and brachial-ankle PWV (baPWV) were evaluated before and after the 40-week therapy.

Results

The baseline and post-therapeutic BP levels were similar among the three groups. At baseline ABPM, non-dipping was observed in 80, 82, and 80% in the V, P, and V+P groups, respectively. Each 40-week therapy regimen comparably reduced ABP. The plasma BNP levels (P<0.0001 for each), left ventricular mass index (LVMI) (P<0.01 for each), and PWV values (P<0.0001 for each) were also reduced. However, when compared with either V or P group, the percentage reduction in LVMI (P<0.05 and P<0.005, respectively), BNP (P<0.05 for each), and baPWV values (P<0.005 and P<0.001, respectively) was greater in the V+P group.

Conclusions

Our findings suggest that, when compared with each monotherapy, perindopril and valsartan combination therapy exerts greater beneficial effects regarding the regression of LVH, reduction in BNP, and improvement of PWV in a selected group of essential hypertensive patients with LVH and high prevalence of non-dipping patterns.

Keywords

Perindopril Valsartan Left ventricular hypertrophy Brain natriuretic peptide Arterial stiffness