Abstract
Objective: Patients with essential hypertension (EH) complicated by type 2 diabetes mellitus (DM) have a high risk of cardiovascular events.The aim of the present study was to evaluate the effects of combination therapy with Valsartan and Amlodipine on BP,left ventricular (LV) hypertrophy,LV diastolic function in patients with EH, type 2 DM and LV hypertrophy. Design and method: Fifty-eight patients with moderate EH,type 2 DM and LV hypertrophy were randomly assigned to Valsartan (80 mg)+Amlodipine (5 mg) in combination once a day(30 males and 28 females).Doppler -and 2-dimensional echocardiography were performed at baseline and after 12 months of therapy.The parameters of LV hypertrophy,ratio of the early filling velocity (E) to the late filling velocity (A)-E/A ratio,isovoluming relaxation time (IVRT) and deceleration time (DT) were evaluated.LV mass index (LV mass/body surface area) was calculated according to the Devereux formula.Statistical comparisons were performed by 2-tailed Student's t test for quantitative parameters. Results: All patients comleted the study without showing intolerance or side effects to the drugs.At the end of the study therapy normalized BP (126,2 ± 3,3/74,5 ± 1,9 mm Hg vs 166,41 ± 5,4/104,3 ± 4,1 mm Hg,p < 0,01) in 94,8% of patients.LV mass index reduced from 158,1 ± 5,7 to 132,5 ± 2,8 g/m2.(p < 0,01) in 79,3 % of patients.At the end of the study E/A ratio increased from 0,91 ± 0,01 to 1,36 ± 0,02 (p < 0,001) in 82,8 % of patients.IVRT decreased from 103,2 ± 5,2 to 74,2 ± 3,1 msec (p < 0,01) in 81,0% of patients.DT passed from 168,2 ± 7,9 to 128,1 ± 3,0 msec (p < 0,01) in 84,5% of patients. Conclusions: BP control was stable and effective until the end of the study.Combination therapy with Valsartan+Amlodipine,wich have complementary mechanisms of action,demonstrated qualitative regression of LV hypertrophy and improvement of LV diastolic function in patients with moderate EH complicated by type 2 DM.In addition,this combination attenuated the side effects of each component.
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