Comparative effects of irbesartan versus nifedipine GITS and metoprolol on left ventricular hypertrophy in hypertensive patients

Objective The aim of this study was to assess the effects of irbesartan,nifedipine gastrointestinal therapeutic system(GITS) and metoprolol on left ventricular hypertrophy(LVH) determined by echocardiograph in patients with mild to moderate untreated hypertension.Methods One hundred and fifity hypertensive patients(102 men and 48 women) with left ventricular hypertrophy were randomized to treat with irbesartan 150～300 mg once daily(group A,34men and 16 women)or nifedipine GITS 30～60 mg once daily(group B,33 men and 17 women) or metoprolol 25～50 mg twice daily(group C,35men and 15 women) for 24 weeks.The blood pressure was measured and the ultrasonic cardiogram examed at the baseline and the end.Results All three drugs reduced ambulatory and clinic BP,but have no significant differences in the pressure decreasing.After 6 months,echocardiographically estimated end-diastolic left ventricular post wall thickness(LVPWT)、 interventricular septal thickness(IVST)、end-diastolic left ventricular diameter(LVDd) and left ventricular mass index(LVMI) were all improved(P0.01).However,the improvement of LVMI in the irbesartan-treated group was more obvious than that of other two groups in LVMI.Conclusion These results suggest that irbesartan、nifedipine and metoprolol all can significantly reduce BP and reverse LVH,but irbesartan is prior to nifedipine and metoprolol in reversing the LVH.