Losartan but not atenolol reduce carotid artery hypertrophy in essential hypertension. A LIFE study

Michael Hecht Olsen*, Kristian Wachtell, Keld Neland, Jonathan N. Bella, Jens Rokkedal, Harriet Dige-Petersen, Hans Ibsen

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    Background. We wanted to investigate whether treatment with losartan, an angiotensin II receptor blocker, induced regression of carotid artery hypertrophy as compared to the beta-receptor blocker, atenolol. Methods. In 45 patients recruited for the LIFE Study with stage II-III hypertension and ECG left ventricular (LV) hypertrophy, we measured blood pressure, intima-media thickness (IMT) and lumen in the common carotid arteries by ultrasound, and minimal forearm vascular resistance (MFVR) by plethysmography, after 2 weeks of placebo treatment and after 1, 2 and 3 years of anti-hypertensive treatment with either atenolol- or losartan-based regimens. We measured the same parameters in 26 normal subjects matched for age and gender. Results. The patients had as compared to normotensive controls higher IMT (0.87 vs 0.76 mm, p=0.001) and intima-media cross-sectional area (IMA) (19.7 vs 15.5 min2, P<0.001). Systolic and diastolic blood pressures were reduced to the same degree in patients treated with losartan as compared to atenolol. However, IMA decreased significantly only in patients treated with losartan (19.2 vs 17.6 mm2, p=0.001) and the average relative decrease in IMA during the 3 years of treatment was significantly higher in patients treated with losartan as compared to atenolol (-7.4 vs -2.0%, p<0.05). Conclusion. Patients with hypertension and LV hypertrophy had hypertrophy of the common carotid arteries. Losartan, but not atenolol, induced regression of this hypertrophy. Because carotid artery hypertrophy has been associated with strokes, our findings may explain the lower incidence of strokes in the LIFE study in patients treated with losartan as compared to atenolol.

    OriginalsprogEngelsk
    Sider (fra-til)177-183
    Antal sider7
    TidsskriftBlood Pressure
    Vol/bind14
    Udgave nummer3
    DOI
    StatusUdgivet - 1 aug. 2005

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