Angiotensin II Type 1 Receptor Antagonist, Losartan, Causes Regression of Left Ventricular Hypertrophy in End-Stage Renal DiseaseShibasaki Y. · Masaki H. · Nishiue T. · Nishikawa M. · Matsubara H. · Iwasaka T.
Department of Medicine II, Kansai Medical University, Moriguchi, Osaka, Japan
Left ventricular hypertrophy (LVH) commonly occurs in patients with end-stage renal disease (ESRD) and is an independent risk factor for cardiovascular events. Angiotensin II type 1 receptor (AT1-R) antagonists may be able to reverse LVH independent to the hypotensive effect in the ESRD setting. Thirty chronically hemodialyzed uremic patients with hypertension were randomly assigned to receive the AT1-R antagonist losartan (n = 10), the angiotensin-converting enzyme (ACD) inhibitor enalapril (n = 10), or calcium antagonist amlodipine (n = 10). Left ventricular mass (LVM) index was measured by echocardiography before and 6 months after treatment. The baseline demographic and clinical characteristics did not differ between the three groups. The mean baseline LVM index also did not differ in the three groups. After 6 months of treatment, losartan treatment significantly reduced the LVM index (–24.7 ± 3.2%) than amlodipine (–10.5 ± 5.2%) or enalapril (–11.2 ± 4.1%) therapy. All three groups had a similar decrease in the mean blood pressure with treatment. The plasma angiotensin II concentration increased 5-fold with losartan treatment. In contrast, the plasma angiotension II concentration did not change with enalapril and only increased 2-fold with amlodipine. Thus, the present study indicates that losartan more effectively regresses LVH in patients with ESRD than do enalapril and amlodipine despite a comparable depressor effect between the three drugs.
Hiroya Masaki, MD
Department of Medicine II, Cardiovascular Center, Kansai Medical University
10–15 Fumizono-cho, Moriguchi
Osaka 570-8507 (Japan)
Fax +81 6 6998 6178, E-Mail firstname.lastname@example.org
Accepted: January 24, 2001
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 2, Number of References : 35
Founded 1964 by G. Richet and G.E. Schreiner
Vol. 90, No. 3, Year 2002 (Cover Date: March 2002)
Journal Editor: G.M. Berlyne, Brooklyn, N.Y./Beersheva; S. Ito, Sendai
ISSN: 0028–2766 (print), 1423–0186 (Online)
For additional information: http://www.karger.com/journals/nef