Hypertension Clinical Trial
Official title:
Randomized, Double-blind Evaluation of the Effects of Irbesartan and Atenolol on Cardiovascular Structure and Function in Subjects With Hypertension and Left Ventricular Hypertrophy
The renin-angiotensin-aldosterone system has been implicated in the control of structural
changes of the heart and the vasculature, beyond the effects on blood pressure.
This projects examines the importance of the renin-angiotensin-aldosterone system and the
sympathetic nervous system in the control of cardiac and vascular structure and function in
subjects with hypertension.Patients with hypertension and left ventricular hypertrophy were
randomized to an angiotensin receptor blocker or a beta adrenergic receptor blocker for 48
weeks. Repeat investigations of blood pressure, structure and function of the heart and the
vascular tree, and neurohormones were performed. Two control groups, consisting of
normotensive subjects and of hypertensive subjects with no cardiac hypertrophy were also
examined for comparison.
We included 115 patients with hypertension and cardiac hypertrophy, established by echocardiography. Extensive echocardiographic examinations, ultrasonography of the carotid arteries, 24h Holter registrations, 24h ambulatory blood pressure monitoring monitoring, neurohormones and blood samples for inflammation and hemostasis markers and endothelial function were done at weeks 0, 12, 24, and 48. Matched control groups (1:3, i.e. 38 normotensive subjects and 38 hypertensive subjects with no signs of hypertensive heart disease were examined at one occasion. All patients obtained irbesartan or atenolol for 12 weeks; a diuretic and a calcium antagonist was added when needed thereafter in order to obtained a blood pressure below 140/90 mm Hg. All analyses were performed central in a core laboratory. ;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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