RELATIONSHIP BETWEEN PARAMETERS OF 24-HOURS BLOOD PRESSURE MONITORING AND ECHOCARDIOGRAPHY PARAMETERS AT BASELINE AND UNDER INDAPAMIDE OR ENALAPRIL THERAPY IN HYPERTENSIVE PATIENTS: PP.26.53

Abstract

The aim of the present study was to investigate the relationship between parameters of 24-hours BP (24-h ABPM) and parameters of echocardiography at baseline and in course of the treatment with indapamid or enalapril. Design and Method: 64 patients: 33 male, 31 female, mean age - 48 ± 6,6 years, mean duration of hypertension 10,4 ± 8,6 were randomized to treatment with either indapamid (32 patients, arifon-retard, Servier, France; 1,5 mg per day) or enalapril (32 patients, ednyt, Gedeon Richter, Hungary; 5–20 mg per day) during 24 weeks. Echocardiography (“Ultramark-9 HDI CV ”, USA), and 24-hours ABPM (“SpaceLabs Medical” 90207 (USA)) were performed at baseline and in course of the treatment. Results: Left ventricular hypertrophy was observed in 33 (51,5%) patients with arterial hypertension. The 24-hour systolic blood pressure (24-h SBP) was positively related to the left ventricular mass (LVM, g) (r = 0,326; p = 0,009) and left ventricular mass index (LVMI, g/m2) (r = 0,313; p = 0,01); 24-hour diastolic blood pressure (24-h DBP) and LVMI (r = 0,267; p = 0,03). Variability of 24-h DBP (r = 0,247; p = 0,050) and variability of day DBP (r = 0,255; p = 0,04) was positively related to the LVMI. Indapamid reduced significantly 24-h SBP (147.1 to 132.6; p < 0.001), 24-h DBP (93.3 to 84.6; p < 0.001); time-index 24-h SBP (79.7 to 41.9; p < 0.001) and time-index 24-h DBP (71.3 to 38.3; p < 0.001). Enalapril reduced significantly 24-h SBP (149.3 to 135.3; p < 0.001), 24-h DBP (93.6 to 85.2; p < 0.001), time-index 24-h SBP (82.1 to 49.1; p < 0.001) and time-index 24-h DBP (66.6 to 41.6; p < 0.001). Indapamid reduced significantly LVM (137,2 to 129,8 g; p = 0,041) and LVMI (121,3 to 115,0 g/m2; p = 0,039). Monotherapy of enalapril was no significant dynamic of LVM (149,9 to 146,7 g; p = 0,570) and LVMI (131,9 to 129,3 g/m2; p = 0,614). The degree of decrease the SBP and DBP was identical in both groups. Conclusions: Left ventricular hypertrophy was related with parameters of 24-h. Therapy of indapamide was more effective than enalapril to decrease of LVMI in hypertensive patients.