Valsartan produced a greater reduction in left ventricular mass index than atenolol (mean reduction 21 vs 10 g/m2; Ratio 0.91, 90% CI 0.85-0.97) after 8 months of treatment.
RCT (n=69)
Double-blind
randomized
Does valsartan reduce left ventricular mass index more than atenolol in patients with essential hypertension and left ventricular hypertrophy?
Valsartan produces a significantly greater regression of left ventricular hypertrophy compared to atenolol in patients with essential hypertension over an 8-month period.
Effect estimate: Ratio 0.91 (95% CI 0.85-0.97 (90% CI))
Absolute Event Rate: 106% vs 117%
BACKGROUND: Left ventricular hypertrophy (LVH) represents an independent risk factor in patients with essential hypertension. Because reversal of LVH may be associated with an improvement of prognosis, the influence of new antihypertensive compounds, such as angiotensin II AT1 receptor antagonists, on LVH should be determined. METHODS AND RESULTS: In a randomized, double-blind trial, 69 predominantly previously untreated hypertensive patients with echocardiographically proven LVH, ie, left ventricular mass index (LVMI) >134 g/m2 in men and >110 g/m2 in women and/or end-diastolic septal thickness >12 mm, received either the angiotensin II antagonist valsartan or atenolol for 8 months. Echocardiographic data of 58 patients were available. After 8 months of valsartan treatment (n=29), LVMI decreased from 127+/-23 to 106+/-25 g/m2 (ratio R=0.83; 95% CI, 0.79 to 0.87; P<0.0001 versus baseline). Under atenolol (n=29), LVMI decreased to a smaller extent, from 127+/-25 to 117+/-27 g/m2 (R=0.92; 95% CI, 0.86 to 0.98; P=0.0082 versus baseline). The mean reduction of LVMI came to 21 g/m2 under valsartan and only to 10 g/m2 under atenolol (R=0.91; 90% CI, 0.85 to 0.97 versus atenolol). Baseline mean blood pressure values were determined to be 163+/-12/101+/-6 mm Hg before treatment with valsartan and 160+/-14/103+/-6 mm Hg before atenolol treatment. After 8 months of treatment, mean blood pressure decreased to 146+/-13/90+/-7 mm Hg with valsartan and to 147+/-18/90+/-7 mm Hg with atenolol. Nine patients in the valsartan group and 8 patients in the atenolol group required additional medication with hydrochlorothiazide. CONCLUSIONS: Antihypertensive treatment with the angiotensin II antagonist valsartan for 8 months produced a significant regression of LVH in predominantly previously untreated patients with essential hypertension. The drug may be safely administered in this subset of hypertensive patients; however, the long-term benefit in terms of risk reduction has still to be evaluated in further trials.
Thürmann et al. (Tue,) conducted a rct in Essential hypertension with left ventricular hypertrophy (n=69). Valsartan vs. Atenolol was evaluated on Left ventricular mass index (LVMI) (Ratio 0.91, 95% CI 0.85-0.97 (90% CI)). Valsartan produced a greater reduction in left ventricular mass index than atenolol (mean reduction 21 vs 10 g/m2; Ratio 0.91, 90% CI 0.85-0.97) after 8 months of treatment.