Freehand three-dimensional echocardiographic evaluation of the effect of
telmisartan compared with hydrochlorothiazide on left ventricular mass in
hypertensive patients with mild-to-moderate hypertension: a multicentre study.
Author(s): Galzerano D(1), Tammaro P, Cerciello A, Breglio R, Mallardo M, Lama D, Tuccillo
B, Capogrosso P.
Affiliation(s): Author information:
(1)Department of Cardiology, San Gennaro Hospital, Naples, Italy.
domenicogalzerano@libero.it
Publication date & source: 2004, J Hum Hypertens. , 18(1):53-9
Antihypertensive efficacy, effects on left ventricular mass index (LVMI) and
tolerability of telmisartan, an angiotensin II receptor blocker, were compared
with those of hydrochlorothiazide (HCTZ). Adult patients with mild-to-moderate
hypertension and an optimal acoustic window by two-dimensional echocardiography
were randomised at baseline to 12 months' double-blind, once-daily treatment with
telmisartan 80 mg or HCTZ 25 mg. Two-dimensional echocardiography and freehand
precordial three-dimensional echocardiography and 24-h ambulatory blood pressure
monitoring were performed at baseline and after treatment. Of the 41 telmisartan
group patients and 28 HCTZ group patients, 40 and 25, respectively, completed the
study. Following treatment, 24-h mean SBP (telmisartan 157 +/- 11 vs 133 +/- 7
mmHg, P<0.001; HCTZ 154 +/- 10 vs 144 +/- 11 mmHg, P<0.003) and DBP (telmisartan
96 +/- 6 vs 83 +/- 5 mmHg, P<0.001; HCTZ 95 +/- 7 vs 87 +/- 8 mmHg, P<0.003) were
significantly reduced. Telmisartan produced significantly greater 24-h mean SBP
and DBP reductions than HCTZ (P<0.001). LVMI was significantly reduced by
telmisartan (141 +/- 16 vs 125 +/- 19 g/m2, P<0.001), but not by HCTZ (139 +/- 20
vs 135 +/- 22 g/m(2)). Incidences of adverse events in both the treatment groups
were low; two cases of hypokalaemia occurred with HCTZ. In conclusion,
telmisartan 80 mg was well tolerated and significantly reduced SBP, DBP and LVMI
after 12 months' treatment compared with HCTZ.
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