Effect of perindopril and metoprolol on left ventricular hypertrophy and performance in essential hypertension.

The effects of perindopril and metoprolol on left ventricular hypertrophy (LVH) and function were studied in 47 essential hypertensive patients with LVH. Previous antihypertensive drugs were discontinued for at least 2 weeks, after which patients were randomly divided into 2 groups. 25 subjects were treated with perindopril 4 to 8 mg once daily in the morning (Group A) and 22 subjects with metoprolol 25 to 62.5 mg twice daily (Group B). The subjects were evaluated before and after 4 and 8 weeks of treatment by use of echocardiography. Before treatment LV mass indexes (LVMI) of two groups were respectively 143.2 +/- 21.3 g/m2 and 140.6 +/- 23.7 g/m2 (P > 0.05). In Group A, reduction of LVMI occurred after 4 weeks of treatment, and more pronounced after 8 weeks (from 143.2 +/- 21.3 g/m2 to 126.6 +/- 15.3 g/m2, P < 0.001), whereas reduction of LVMI occurred only after 8 weeks in Group B (from 140.6 +/- 23.7 g/m2 to 133.4 +/- 13.2 g/m2, P < 0.001). In addition, there was a significant (P < 0.05) difference in LVMI between the two groups after 8 weeks. LV systolic function remained unchanged, whereas E/A increased significantly (P < 0.001) in two groups after 8 weeks. In conclusion, antihypertensive treatment with perindopril and metoprolol induced a significant regression of LVH associated with improvement in LV diastolic performance. Perindopril, compared with metoprolol, was more effective in reversing LVH.