Ventricular Mass and Atrial Size in Diabetic Hypertensive Patients Using Losartan or Benazepril.
Abstract
Background: Hypertensive diabetic patients are more likely to develop left ventricular hypertrophy and atrial fibrillation. Evidence suggests that renin-angiotensin-aldosterone system blockers should be used in this group of patients. Objective: To evaluate if there are differences between the effects of angiotensin-converting enzyme benazepril and the angiotensin-receptor blocker losartan on left atrial size and ventricular mass when associated to the treatment of diabetic hypertensive patients using amlodipine. Methods: 34 hypertensive type-2 diabetic outpatients from the Internal Medicine service of Universidade do Estado do Rio de Janeiro were randomized into two groups, after a period of 6 weeks receiving only amlodipine, to receive losartan or benazepril. At the beginning and end of the combined treatment, patients were submitted to echocardiography for cavity assessment, wall thickness and flow measurements. Results: There was reduction in left ventricular mass index in the losartan group (from 81.1 ± 23.5 to 76.9 ± 23.8 g/m²; p = 0.044), with no difference in the benazepril group (from 81.8 ± 10.8 to 79.7 ± 12.1 g/m²; p = 0.520). The left atrial diameter index was lower at 12 weeks (p = 0.034) in the losartan group, which ranged from 2.12 ± 0.23 to 2.03 ± 0.22 cm/m² (p = 0.103) when compared to the benazepril group, which ranged from 2.12 ± 0.30 to 2.23 ± 0.29 cm/m² (p = 0.064). Conclusion: The losartan and amlodipine combination was better than the benazepril and amlodipine combination for left ventricular mass and left atrial size reduction in this sample of type 2 diabetic hypertensive patients. (Int J Cardiovasc Sci. 2016;29(3):181-188)Keywords: Diabetes Mellitus; Hypertrophy, Left Ventricular; Hypertension; Atrial Fibrillation; Renin-Angiotensin System.
International Journal of Cardiovascular Sciences, v. 29, p. 181-188, 2016.