title: Two-year follow-up study to evaluate the reduction of left ventricular mass and diastolic function in mild to moderate diastolic hypertensive patients.
abstract: OBJECTIVE
  To compare the effects of two antihypertensive agents, amlodipine and lisinopril, on left ventricular mass and diastolic filling in patients from primary care centers with mild to moderate diastolic hypertension.
  
  
  METHODS
  A second-year, open follow-up of a prospective, double-blind, randomized, parallel group, comparative study.
  
  
  METHODS
  Male and female patients between 25 and 75 years-of-age with elevated diastolic blood pressure (four measurements > or = 95 mmHg from multiple measurements taken on three occasions and average diastolic blood pressure < 115 mmHg) were recruited from a population survey. After 4 weeks' placebo run-in, 71 patients were included of whom 60 finished the first study year and 51 finished the second study year. Patients were randomly assigned to receive doses of 5-10 mg amlodipine or 10-20 mg lisinopril, which were titrated on the basis of the effects on blood pressure. Primary endpoints were left ventricular mass index (LVMI) and early to atrial peak filling velocity. Office and ambulatory blood pressure were considered secondary endpoints.
  
  
  RESULTS
  The decrease in blood pressure was equal for both treatment regimens in the first year. A statistically significant (P< 0.001) decrease in LVMI in both treatment groups was observed in the first year [-11.0 g/m2 (95% Cl -6.0 to -16.1) in the amlodipine group and -12.6 g/m2 (95% Cl -8.2 to -17.0) in the lisinopril group]. Early to atrial peak filling velocity did not change significantly within the treatment groups in the first year [+0.07 (95% CI -0.01 to +0.15) in the amlodipine group and +0.01 (95%9 Cl -0.06 to +0.08) in the lisinopril group. Blood pressure, LVMI and early to atrial peak filling velocity did not change in the second year of treatment. No significant differences in primary and secondary endpoints between treatment groups were found in the first or second year.
  
  
  CONCLUSIONS
  The effects of amlodipine and lisinopril on left ventricular mass and early to atrial filling peak velocity after 2 years of treatment were similar and these effects were already observed after 1 year of treatment. Additional studies of longer duration (> or = 4 years) and with a larger sample size are recommended.
authors.affiliation: Department of General Practice, University of Groningen, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Beltman
authors.forename: W
authors.initials: W
authors.lastname: Heesen
authors.forename: A
authors.initials: A
authors.lastname: Smit
authors.forename: J
authors.initials: J
authors.lastname: May
authors.forename: P
authors.initials: P
authors.lastname: de Graeff
authors.forename: T
authors.initials: T
authors.lastname: Havinga
authors.forename: F
authors.initials: F
authors.lastname: Schuurman
authors.forename: E
authors.initials: E
authors.lastname: van der Veur
authors.forename: K
authors.initials: K
authors.lastname: Lie
authors.forename: B
authors.initials: B
authors.lastname: Meyboom-de Jong
mesh_terms: D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D003971:Diastole / Q000502:physiology; D004311:Double-Blind Method; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D017706:Lisinopril / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D017311:Amlodipine; D017706:Lisinopril