Intervention Study On Left Ventricular Hypertrophy In Young And Middle-aged Patie Nts With Diastolic Hype Rte Nsion Resulting From Mental Stress

Objective:To evaluate antihypertensive efficacy and reverse effect on left ventricular hypertrophy of valsartan and metoprolol in treatment of young and middle-aged patients with diastolic hypertension related to mental stress.Methods:120 cases were randomized into 3 groups: valsartan group,metoprolol group,valsartan and metoprolol group(also named as the combination group).There were 40 cases in each group.After 6-month treatment,total effective rate,blood pressure,heart rate,interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass index(LVMI),Cornell index,Sokolow index and adverse reactions of 3 groups were compared.Results:(1)After treatment,blood pressure,IVST,LVPWT,LVMI,Cornell index,Sokolow index were improved significantly compared with those before treatment(P<0.05).Heart rate was improved significantly in the metoprolol group and the combination group(P<0.05).(2)The total effective rates of three groups were 85.0%,82.5% and 95.0%,and they had no statistically significant difference(P>0.05).(3)The systolic blood pressure of the metoprolol group was higher than that of the valsartan group and the combination group,the difference was statistically significant(P <0.05).There was no significant difference in the systolic blood pressure between the valsartan group and the combination group(P> 0.05).The levels of diastolic blood pressure after treatment were statistically significant(P <0.05).The heart rate of valsartan group was higher than that of the other two groups(P< 0.05).There was no significant difference between the metoprolol group and the combination group(P> 0.05).(4)The IVST,LVPWT,LVMI of the valsartan and metoprolol group were significantly improved compared with the valsartan group and the metoprolol group(P<0.05).(5)The sensitivity of Cornell index in the patients with left ventricular hypertrophy was 32.5%,35.0% and 35.0% and that of Sokolow index was 37.5%,37.5% and 42.5%,respectively.There was no significant difference among groups(P> 0.05).In positive Cornell index and Sokolow index group,Cornell index and Sokolow index decreased significantly(P <0.05).The Cornell index was higher in the valsartan group than the other two groups.There was no significant difference compared with the metoprolol group(P> 0.05).Compared with the combination group,the difference was statistically significant(P <0.05).There was no significant difference in Cornell index between the metoprolol group and the combination groups(P> 0.05).The Sokolow index of valsartan group was higher than that of the other two groups(P <0.05).There was no significant difference in Sokolow index between the metoprolol group and the combination groups(P> 0.05).(6)During the treatment period,no severe adverse reaction appeared in three groups.Conclusion:Both valsartan and metoprolol could lower the blood pressure effectively and re verse left ventricular hypertrophy of young and middle-aged patients with diastolic hypertension resulting from mental stress.But the clinical efficacy of combination therapy was better than that of valsartan or metoprolol alone.