title: Effects of the combinations of amlodipine/valsartan versus losartan/hydrochlorothiazide on left ventricular hypertrophy as determined with magnetic resonance imaging in patients with hypertension.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH), a marker of cardiac end-organ damage, is frequently found in patients with arterial hypertension and is associated with cardiovascular and cerebrovascular morbidity and mortality. Therefore, LVH regression is an important treatment goal. For amlodipine plus valsartan (A/V) no specific study on LVH has been reported to date.
  
  
  METHODS
  Prospective, open-label, randomized parallel-group study. Patients with essential hypertension and LVH were randomized to 52-week treatment with A/V 10/160 mg (n = 43) or the active comparator losartan/HCT 100/25 mg (L/H, n = 47). Add-on medication was allowed in case of inadequate blood pressure control. LV parameters were measured by cardiovascular magnetic resonance imaging (MRI), and adjudicated in a blinded manner. Study identifiers were NCT00446563 and EudraCT 2006-001977-17.
  
  
  RESULTS
  In addition to the study treatment, 35% of patients in the A/V group and 49% in the L/H group received additional antihypertensive medication. Compared to baseline, both treatments reduced measures of LVH significantly after 52 weeks (e.g. LV mass index in the A/V group from 64.7 g/m(2) by -3.5 g/m(2), in the L/H group from 69.1 g/m(2) by -4.4 g/m(2), p < 0.01 for both). LV ejection fraction and LV volumes were not significantly changed by any regimen. A/V and L/H treatments were well tolerated.
  
  
  CONCLUSIONS
  Both regimen were effective in reducing LV mass compared to baseline and were well tolerated.
authors.affiliation: Department of Cardiology and Angiology, Elisabeth Hospital, Essen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bruder
authors.affiliation: Department of Cardiology and Angiology, Elisabeth Hospital, Essen, Germany.
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Jensen
authors.affiliation: Department of Cardiology and Angiology, Elisabeth Hospital, Essen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Bell
authors.affiliation: Office-based cardiologist, Berlin, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Rummel
authors.affiliation: Office-based internist, Ludwigshafen, Germany.
authors.forename: Guenter
authors.initials: G
authors.lastname: Boehm
authors.affiliation: Novartis Pharma GmbH, Clinical and Regulatory Affairs, Nürnberg, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Klebs
authors.affiliation: Novartis Pharma GmbH, Clinical and Regulatory Affairs, Nürnberg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Sieder
authors.affiliation: Institute for Myocardial Infarction Research, Ludwigshafen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
keywords: A/V, amlodipine plus valsartan; Arterial hypertension; Asc. aorta, ascending aorta; BP, diastolic blood pressure; CCB, calcium channel blockers; IVS, interventricular septum thickness; L/H, losartan/hydrochlorothiazide; LA, left atrium; LVEDV, left ventricular enddiastolic volume; LVEF, left ventricular ejection fraction; LVESV, left ventricular endsystolic volume; LVH, left ventricular hypertrophy; LVM, left ventricular mass; LVMI, left ventricular mass index; MRI, magnetic resonance imaging; RAAS; SBP, systolic blood pressure; combination therapy; end-organ damage; left ventricular hypertrophy; magnetic resonance imaging; norm BSA, adjusted for body surface area; treatment