Left ventricular mass and mechanics in mild-to-moderate hypertension: effect of nebivolol versus telmisartan.
BACKGROUND
The aim of this study was to compare the effects of nebivolol and telmisartan on left ventricular mass (LVM) and midwall mechanics in mild-to-moderate hypertension.


METHODS
A total of 40 patients with mild-to-moderate hypertension were randomized to receive either nebivolol (2.5 to 5.0 mg/day) or telmisartan (40 to 80 mg/day) to achieve a target diastolic blood pressure of <90 mm Hg. Blood pressure (BP) was measured with sphygmomanometry, and LVM and midwall fractional shortening (mFS) were estimated by two-dimensionally guided M-mode echocardiography at baseline and at 3-month follow-up.


RESULTS
Age, sex distribution, and baseline SBP and DBP and heart rate were similar in the two groups. Both nebivolol and telmisartan reduced systolic (156 +/- 7 v 124 +/- 8 mm Hg, P < .01, and 153 +/- 5 v 120 +/- 7 mm Hg, P < .01, respectively) and DBP (99 +/- 4 v 80 +/- 2 mm Hg, P < .01 and 98 +/- 2 v 80 +/-2 mm Hg, P < .01, respectively) and increased mFS (16% +/- 2% v 19% +/- 2%, P < .01, and 15% +/- 2% v 18% +/- 2%, P < .01, respectively). The LVM indices decreased significantly with both nebivolol (98 +/- 16 v 84 +/- 13 g/m(2), P < .01) and telmisartan (97 +/- 13 v 83 +/- 8 g/m(2), P < .01). We found that mFS was inversely related to DBP in the nebivolol but not in the telmisartan group.


CONCLUSIONS
In mild-to-moderate hypertension, nebivolol and telmisartan are equally effective in reducing BP and increasing mFS. There may be differences between nebivolol and telmisartan regarding the mechanism of increase in mFS.
Fountoulaki
Katerina
K
Department of Cardiology, Larissa University Hospital, Larissa, Greece.
Dimopoulos
Vasilis
V
Giannakoulis
John
J
Zintzaras
Elias
E
Triposkiadis
Filippos
F
D058671:Adrenergic beta-1 Receptor Antagonists; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D001578:Benzopyrans / Q000627:therapeutic use*; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000187:drug effects; D003971:Diastole; D004452:Echocardiography; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology; D009200:Myocardial Contraction / Q000187:drug effects; D000068577:Nebivolol; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D000077333:Telmisartan; D016277:Ventricular Function, Left / Q000187:drug effects*
D058671:Adrenergic beta-1 Receptor Antagonists; D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol; D000077333:Telmisartan