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document
Comparative effects of valsartan versus amlodipine on left ventricular mass and reactive oxygen species formation by monocytes in hypertensive patients with left ventricular hypertrophy . OBJECTIVES To compare the effects of the angiotensin receptor blocker ( ARB ) valsartan versus the calcium channel blocker amlodipine , reactive oxygen species ( ROS ) formation by monocytes , C-reactive protein ( CRP ) , and left ventricular ( LV ) mass were studied in 104 hypertensive patients with left ventricular hypertrophy ( LVH ) . BACKGROUND There is evidence that ARBs have blood pressure ( BP ) -independent effects on LV mass . Whether regression of LV mass by ARBs is correlated to ROS formation by monocytes and CRP is not fully understood yet . METHODS A cross-sectional and prospective study was performed . Participants were randomly assigned to either the 80-mg valsartan ( n = 52 ) or 5-mg amlodipine ( n = 52 ) group and were treated for eight months . The left ventricular mass index ( LVMI ) was calculated from two-dimensional M-mode echocardiography . Formation of ROS by monocytes was measured by gated flow cytometry . In addition , CRP , plasma renin activity , plasma aldosterone , and traditional risk factors were assessed . RESULTS Multiple regression analysis showed a significant correlation between LVMI and ROS formation by monocytes and between LVMI and CRP . Treatment reduced BP to a similar extent in both groups . Valsartan significantly reduced LVMI after eight months , but amlodipine had less effect ( 16 % vs. 1.2 % , n = 50 , p < 0.01 ) . Formation of ROS by monocytes was reduced to a greater extent with valsartan than with amlodipine ( 28 % vs. 2 % , n = 50 , p < 0.01 ) . Valsartan but not amlodipine reduced CRP levels . A significant correlation between changes in ROS formation by monocytes and LVMI or between CRP and LVMI was observed . CONCLUSIONS The ARB valsartan has BP-independent effects on LVH , ROS formation by monocytes , and CRP in hypertensive patients with LVH .
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Intervention_Pharmacological
valsartan
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Intervention_Pharmacological
amlodipine
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Intervention_Pharmacological
angiotensin receptor blocker ( ARB ) valsartan
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Intervention_Pharmacological
calcium channel blocker amlodipine
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Intervention_Pharmacological
ARBs
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Intervention_Pharmacological
ARBs
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Intervention_Pharmacological
80-mg valsartan
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Intervention_Pharmacological
5-mg amlodipine
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Intervention_Pharmacological
Valsartan
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Intervention_Pharmacological
amlodipine
17160
Intervention_Pharmacological
valsartan
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Intervention_Pharmacological
amlodipine
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Intervention_Pharmacological
Valsartan
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Intervention_Pharmacological
amlodipine
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Intervention_Pharmacological
ARB valsartan
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Outcome_Physical
Treatment reduced BP
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Outcome_Physical
similar extent
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Outcome_Physical
Valsartan significantly reduced LVMI
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Outcome_Other
less effect
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Outcome_Physical
Formation of ROS by monocytes
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Outcome_Physical
reduced CRP levels
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Outcome_Other
significant correlation
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Outcome_Physical
changes in ROS formation by monocytes and LVMI or between CRP and LVMI
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Participant_Condition
hypertensive patients with left ventricular hypertrophy .