Efficacy of irbesartan combined with diltiazem on essential hypertension

Abstract

Objective To evaluate the effect of irbesartan combined with diltiazem on myocardial ischemia and left ventricular remodeling in patients with essential hypertension. Methods A total of 166 patients with essential hypertension in Jiaozhou People’s Hospital from July 2016 to June 2018 were randomly divided into treatment group and control group, with 83 cases in each group. The control group received 150 mg of irbesartan tablets orally. The treatment group took 30 mg of diltiazem on the basis of treatment of the control group. After treatment, the patients were followed up for 3 months, and the patient’s adverse reactions were recorded. The blood pressure of the patients was dynamically detected during the treatment. Three days after treatment, the changes of AVF, MV1 and MV5 leads were continuously detected by dynamic electrocardiograph for 24 h. The patient’s myocardial ischemia and total ischemia burden(TIB) were monitored. Echocardiographic parameters were measured and compared before and after treatment, including left ventricular end diastolic diameter (LVEDD), left ventricular diastolic posterior wall thickness (LVPWT) and left ventricular septal thickness (LVST), left ventricular mass index (LVMI) and left ventricular mass (LVM). Results Compared with those before treatment, the 24 h, daytime and night systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate of the patients in the treatment group decreased (P all<0.05), and were lower than those in the control group at the same time (P<0.05). Compared with before treatment, the total TIB, AVF, MV1 and MV5 leads in the treatment group decreased (P all<0.05), while the total TIB leads in the treatment group decreased (P all<0.05) in all time intervals (0-6 h, 6-12 h, 12-18 h and 18-24 h), and the above indexes were lower than those in the control group at the same time after treatment (P all<0.05). Compared with those before treatment, LVPWT, LVMI, IVST and LVEDD were all lower in both groups (P all<0.05). After treatment, the above echocardiographic indexes in the treatment group were lower than those in the control group (P all<0.05). There was no significant difference in the incidence of adverse reactions between the treatment group and the control group [χ2=0.073, P=0.787, 8.4% (7/83) vs.9.6% (8/83)]. Conclusions The combination of irbesartan and diltiazem in patients with essential hypertension can effectively reverse left ventricular remodeling and improve myocardial ischemia, without increasing the incidences of adverse reactions, which is worthy of clinical application. Key words: Essential hypertension; Irbesartan; Diltiazem