A Clinical Study Of Cozaar On Blood Pressure, Left Ventricular Hypertrophy And Left Ventricular Function In Essential Hypertension

Objects: To investigate the antihypertensive efficacy and the effects on left ventricular hypertrophy (LVH), and left ventricular function in patients with essential hypertension (EH). Methods: Thirty-four patients with mild to moderate EH were given Cozaar 50mg once daily for four weeks. Before and after the treatment, sitting systolic blood pressure (BP) and diastolic BP (SiSBP/SiDBP) heart rate (HR) were measured, Echocardiography was conducted to determine cardiac structure and function, left ventricular mass (LVM), LVM index (LVMI) and identical volume relax time (IVRT). Meanwhile, ambulatory blood pressure monitoring (ABPM) was applied to determine 24-hour, daytime and nighttime systolic BP (SBP), diastolic BP (DBP), mean arterial BP (MAP) , BP load (BPL), BP variability (BPV) , trough-to-peak ratio. Metabolic parameters such as blood lipid and fasting blood glucose, serum uric acid and renal function were measured before and after the treatment. Results: Four weeks treatment with Cozaar significantly decreased SiSBP/SiDBP, decreasing range of BP were (21.25±10.48)7 (15.44±9.67)mmHg, (1mmHg=0.1333Kpa), P<0.001, total effective rate was 96.87%. SBP, DBP and MAP during 24-hour, daytime and nighttime were reduced significantly, P<0.001, BPL(P<0.001), BPV( P<0.001) were reduced, T/P>50%. There was no significantly difference about HR and cardiac output, but left atrium diameter (LA), left ventricular diastolic diameter (LVIDd), interventricular septal thickness (IVST), left ventricular posterior wall thickness(LVPWT), LVM, LVMI were all reduced (P<0.001-0.01), ejection fraction (EF) was increased (P<0.05), diastolic prime blood filling was improved (P<0.001-0.05), IVRT was shortened from baseline (P<0.001). Blood uric acid was reduced after the treatment, but it had no effect on fasting blood glucose, blood lipid, serum creatinine, urea nitrogen before and after the treatment. Conclusion: In patients with mild to moderate essential hypertension, Cozaar can effectively and steadily reduce blood pressure during 24-hour, reverse LVH, improve left ventricular diastolic function, lower serum uric acid and be generally well tolerated and less adverse effects.