title: Effect of long-term eprosartan versus enalapril antihypertensive therapy on left ventricular mass and coronary flow reserve in stage I-II hypertension. Eprosartan Study Group.
abstract: A double-blind comparator study was performed in 528 hypertensive patients [baseline sitting diastolic blood pressure (SitDBP) 95-114 mmHg]. The primary objective was to compare the incidence of drug-related cough in patients treated with enalapril and eprosartan. This paper reports the results of 27 asymptomatic patients who were recruited into a single centre substudy of the multicentre trial and randomised to receive either eprosartan (200-300 mg b.i.d.) or enalapril (5-20 mg o.d.). Blood pressure (BP) reduction, left ventricular (LV) mass regression and change in coronary flow reserve (CFR) after 6 months' treatment with either eprosartan or enalapril were compared. At the end of the study, eprosartan and enalapril were found to have caused similar reductions in BP. There was an increase in CFR in the eprosartan group to 1.6 +/- 0.3 and a decrease in CFR in the enalapril group to 1.3 +/- 0.3. Neither value was significantly different from baseline although the difference between the two groups was significant (p = 0.05). By study endpoint, there was a significant reduction in LV mass in the enalapril group (p = 0.05), but not the eprosartan (p = ns) group. Further investigation of the effects of angiotensin receptor blockers on CFR and LV mass regression appear warranted.
authors.affiliation: Hypertension Section, Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY 10029-6574, USA. joseph_diamond@smtplink.mssm.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Diamond
authors.forename: A
authors.initials: A
authors.lastname: Gharavi
authors.forename: D
authors.initials: D
authors.lastname: Roychoudhury
authors.forename: J
authors.initials: J
authors.lastname: Machac
authors.forename: M J
authors.initials: MJ
authors.lastname: Henzlova
authors.forename: A
authors.initials: A
authors.lastname: Travis
authors.forename: R A
authors.initials: RA
authors.lastname: Phillips
mesh_terms: D000179:Acrylates / Q000627:therapeutic use*; D000804:Angiotensin II / Q000037:antagonists & inhibitors*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003326:Coronary Circulation / Q000187:drug effects; D004311:Double-Blind Method; D004656:Enalapril / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D007093:Imidazoles / Q000627:therapeutic use*; D013876:Thiophenes
chemical_list: D000179:Acrylates; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D007093:Imidazoles; D013876:Thiophenes; D000804:Angiotensin II; C068373:eprosartan; D004656:Enalapril