Effects of valsartan or ramipril addition to amlodipine/hydrochlorothiazide combination on left ventricular mass in diabetic hypertensive patients with left ventricular hypertrophy

Roberto Fogari, Annalisa Zoppi, Amedeo Mugellini, Pamela Maffioli, Paola Preti, Giuseppe Derosa

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: The objective of this study was to compare valsartan or ramipril addition to amlodipine hydrochlorothiazide (HCTZ) on blood pressure (BP) and left ventricular hypertrophy (LVH) in hypertensive diabetic patients with LVH. Research design and methods: 293 patients were treated with amlodipine 10 mg HCTZ 12.5 combination and then randomized to receive valsartan 160 mg or ramipril 5 mg, in addition to the previous therapy, for 1 year. Main outcome measures: Clinic BP was measured every month; echocardiographic assessments were performed at the end of the placebo period, both before the randomization and after 1-year of triple combination therapy. Results: Both triple regimens similarly reduced SBP/DBP values (-13.5/10.9 mm Hg in the valsartan group and -13.4/10.4 mm Hg in the ramipril group). Triple combination including valsartan better reduced LVMI (-20.1%, p <0.001), interventricular septal thickness (IVST) (-20.3%, p <0.001) and left ventricular posterior wall thickness (PWT) (-16.3%, p <0.001), compared with triple combination including ramipril (-14%, p <0.01; -16.2%, p <0.001 and -9%, p <0.01, respectively); the difference between treatments being statistically significant (p <0.05). Triple combination with valsartan gave a greater increase of E/A ratio (p <0.05 between groups). Conclusions: Valsartan addition to dual therapy with amlodipine HCTZ was more effective than ramipril addition in reducing LVH.

Original languageEnglish
Pages (from-to)1091-1099
Number of pages9
JournalExpert Opinion on Pharmacotherapy
Volume13
Issue number8
DOIs
Publication statusPublished - Jun 2012

Fingerprint

Valsartan
Ramipril
Amlodipine
Hydrochlorothiazide
Left Ventricular Hypertrophy
Blood Pressure
Therapeutics
Random Allocation
Research Design
Placebos
Outcome Assessment (Health Care)

Keywords

  • Amlodipine
  • Ramipril
  • Triple therapy
  • Type 2 diabetes mellitus
  • Valsartan
  • Ventricular hypertrophy

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

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title = "Effects of valsartan or ramipril addition to amlodipine/hydrochlorothiazide combination on left ventricular mass in diabetic hypertensive patients with left ventricular hypertrophy",
abstract = "Objective: The objective of this study was to compare valsartan or ramipril addition to amlodipine hydrochlorothiazide (HCTZ) on blood pressure (BP) and left ventricular hypertrophy (LVH) in hypertensive diabetic patients with LVH. Research design and methods: 293 patients were treated with amlodipine 10 mg HCTZ 12.5 combination and then randomized to receive valsartan 160 mg or ramipril 5 mg, in addition to the previous therapy, for 1 year. Main outcome measures: Clinic BP was measured every month; echocardiographic assessments were performed at the end of the placebo period, both before the randomization and after 1-year of triple combination therapy. Results: Both triple regimens similarly reduced SBP/DBP values (-13.5/10.9 mm Hg in the valsartan group and -13.4/10.4 mm Hg in the ramipril group). Triple combination including valsartan better reduced LVMI (-20.1{\%}, p <0.001), interventricular septal thickness (IVST) (-20.3{\%}, p <0.001) and left ventricular posterior wall thickness (PWT) (-16.3{\%}, p <0.001), compared with triple combination including ramipril (-14{\%}, p <0.01; -16.2{\%}, p <0.001 and -9{\%}, p <0.01, respectively); the difference between treatments being statistically significant (p <0.05). Triple combination with valsartan gave a greater increase of E/A ratio (p <0.05 between groups). Conclusions: Valsartan addition to dual therapy with amlodipine HCTZ was more effective than ramipril addition in reducing LVH.",
keywords = "Amlodipine, Ramipril, Triple therapy, Type 2 diabetes mellitus, Valsartan, Ventricular hypertrophy",
author = "Roberto Fogari and Annalisa Zoppi and Amedeo Mugellini and Pamela Maffioli and Paola Preti and Giuseppe Derosa",
year = "2012",
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TY - JOUR

T1 - Effects of valsartan or ramipril addition to amlodipine/hydrochlorothiazide combination on left ventricular mass in diabetic hypertensive patients with left ventricular hypertrophy

AU - Fogari, Roberto

AU - Zoppi, Annalisa

AU - Mugellini, Amedeo

AU - Maffioli, Pamela

AU - Preti, Paola

AU - Derosa, Giuseppe

PY - 2012/6

Y1 - 2012/6

N2 - Objective: The objective of this study was to compare valsartan or ramipril addition to amlodipine hydrochlorothiazide (HCTZ) on blood pressure (BP) and left ventricular hypertrophy (LVH) in hypertensive diabetic patients with LVH. Research design and methods: 293 patients were treated with amlodipine 10 mg HCTZ 12.5 combination and then randomized to receive valsartan 160 mg or ramipril 5 mg, in addition to the previous therapy, for 1 year. Main outcome measures: Clinic BP was measured every month; echocardiographic assessments were performed at the end of the placebo period, both before the randomization and after 1-year of triple combination therapy. Results: Both triple regimens similarly reduced SBP/DBP values (-13.5/10.9 mm Hg in the valsartan group and -13.4/10.4 mm Hg in the ramipril group). Triple combination including valsartan better reduced LVMI (-20.1%, p <0.001), interventricular septal thickness (IVST) (-20.3%, p <0.001) and left ventricular posterior wall thickness (PWT) (-16.3%, p <0.001), compared with triple combination including ramipril (-14%, p <0.01; -16.2%, p <0.001 and -9%, p <0.01, respectively); the difference between treatments being statistically significant (p <0.05). Triple combination with valsartan gave a greater increase of E/A ratio (p <0.05 between groups). Conclusions: Valsartan addition to dual therapy with amlodipine HCTZ was more effective than ramipril addition in reducing LVH.

AB - Objective: The objective of this study was to compare valsartan or ramipril addition to amlodipine hydrochlorothiazide (HCTZ) on blood pressure (BP) and left ventricular hypertrophy (LVH) in hypertensive diabetic patients with LVH. Research design and methods: 293 patients were treated with amlodipine 10 mg HCTZ 12.5 combination and then randomized to receive valsartan 160 mg or ramipril 5 mg, in addition to the previous therapy, for 1 year. Main outcome measures: Clinic BP was measured every month; echocardiographic assessments were performed at the end of the placebo period, both before the randomization and after 1-year of triple combination therapy. Results: Both triple regimens similarly reduced SBP/DBP values (-13.5/10.9 mm Hg in the valsartan group and -13.4/10.4 mm Hg in the ramipril group). Triple combination including valsartan better reduced LVMI (-20.1%, p <0.001), interventricular septal thickness (IVST) (-20.3%, p <0.001) and left ventricular posterior wall thickness (PWT) (-16.3%, p <0.001), compared with triple combination including ramipril (-14%, p <0.01; -16.2%, p <0.001 and -9%, p <0.01, respectively); the difference between treatments being statistically significant (p <0.05). Triple combination with valsartan gave a greater increase of E/A ratio (p <0.05 between groups). Conclusions: Valsartan addition to dual therapy with amlodipine HCTZ was more effective than ramipril addition in reducing LVH.

KW - Amlodipine

KW - Ramipril

KW - Triple therapy

KW - Type 2 diabetes mellitus

KW - Valsartan

KW - Ventricular hypertrophy

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DO - 10.1517/14656566.2012.683175

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