Effect of Different Variants of Hypotensive Therapy on Structural Remodeling of the Heart

Abstract

Background: The remodeling of heart in the light of modern concepts often in essential degree can complicate the course of arterial hypertension, acting not only as a factor that contributes to complications, but also further progression of the disease.
Material and methods: 124 patients (86 men and 38 women) with arterial hypertension of degree I-III with mean age of 55.7±1.0 years were studied. The patients underwent cardiac echocardiography with cardiac remodeling and its type being assessed. After baseline examination, patients received hypotensive therapy with azilsartan medoxomil, losartan, prestans and triplixam for 12 months. Patients with I-II degrees of arterial hypertension were prescribed azilsartan medoxomil or losartan, with II-III degrees – perindopril+amlodipine (prestans) or perindopril+indapamide+amlodipine (triplixam). The studies were repeated after 6 and 12 months.
Results of the study: In terms of the effect on cardiac remodeling, azilsartan medoxomil prevailed over losartan among patients with arterial hypertension degrees I-II. Among patients with II-III degrees of arterial hypertension, triplixam prevailed over prestans. Positive changes were mediated by decreased left ventricular relative wall thickness, myocardial mass, and left ventricular myocardial mass index.
Conclusions: In the aspect of the influence on the cardiac remodeling in patients with I-II degrees of arterial hypertension, azilsartan medoxomil was superior to losartan, and in patients with II-III degrees of arterial hypertension – perindopril+indapamide+amlodipine versus perindopril+amlodipine.