Hadi Najah R, Abdulzahra Mohammad S, Al-Huseini Laith M, Al-Aubaidy Hayder A
Department of Pharmacology and Therapeutics, College of Medicine, University of Kufa, Iraq.
Department of Medicine, College of Medicine, University of Kufa, Iraq.
Int J Cardiol. 2017 Mar 1;230:269-274. doi: 10.1016/j.ijcard.2016.12.127. Epub 2016 Dec 22.
Hypertension-induced cardiac dysfunction is variable among different anti-hypertensive medications. This study compares the effects of telmisartan and enalapril on echocardiographic parameters in hypertensive patients.
This was a randomised single blinded study. Eighty hypertensive patients were included in this study and they were randomly allocated into two study groups: Group 1 included 40 patients who took telmisartan 80mg once daily for six months. Group 2 included 40 patients who took enalapril, 20mg once daily for six months. An additional 40 healthy participants were enrolled in the study as controls (Group 3). Baseline echocardiographic scan was done at the start of the study and after 6 months of treatment including assessment of left ventricular systolic and diastolic functions with assessment of left ventricular mass index, in addition to measurements of blood pressure, heart rate and double product.
Both group 1 and group 2 (telmisartan and enalapril groups respectively) showed comparable statistically significant improvement in the diastolic functional parameters (P<0.010), while both medications didn't demonstrate changes in the systolic functional parameters. Furthermore, telmisartan was significantly effective in reducing the interventricular septal thickness and left ventricular mass index (P<0.010).
Both drugs interfere with renin-angiotensin aldosterone system, protecting the myocardium from high blood pressure. Findings from our study provide key results for physicians in deciding the appropriate antihypertensive drug for each patient depending based on the patient's intolerability for either medication.
高血压引起的心脏功能障碍在不同的抗高血压药物之间存在差异。本研究比较了替米沙坦和依那普利对高血压患者超声心动图参数的影响。
这是一项随机单盲研究。本研究纳入了80例高血压患者，他们被随机分为两个研究组：第1组包括40例患者，他们每天服用一次80mg替米沙坦，持续6个月。第2组包括40例患者，他们每天服用一次20mg依那普利，持续6个月。另外40名健康参与者作为对照组纳入研究（第3组）。在研究开始时以及治疗6个月后进行基线超声心动图扫描，包括评估左心室收缩和舒张功能以及左心室质量指数，此外还测量血压、心率和双乘积。
第1组和第2组（分别为替米沙坦组和依那普利组）在舒张功能参数方面均显示出具有统计学意义的可比改善（P<0.010），而两种药物在收缩功能参数方面均未显示出变化。此外，替米沙坦在降低室间隔厚度和左心室质量指数方面具有显著效果（P<0.010）。
两种药物均干扰肾素 - 血管紧张素 - 醛固酮系统，保护心肌免受高血压影响。我们的研究结果为医生根据患者对每种药物的耐受性为每位患者选择合适的抗高血压药物提供了关键依据。
