Effects of aliskiren on blood pressure and myocardial function assessed by global longitudinal strain in patients with arterial hypertension and diastolic dysfunction.

OBJECTIVE To evaluate the effects of aliskiren on blood pressure and myocardial function assessed by global longitudinal strain in patients with uncontrolled arterial hypertension. PATIENTS AND METHODS Forty-five patients were included in the study (29 males, 16 females, mean age 58.7 +/- 12.4 years) with BP > 140/90 mmHg despite treatment with combined antihypertensive therapy and echocardiographic data for diastolic dysfunction: E/E'ratio < or = 8, E/A ratio < 0.8, deceleration time (DT) > 200 msec. Aliskiren (2 x 150 mg per day) was added to the previous therapy. The follow-up period was 1 year, including monthly clinical visits. Echocardiographic assessment of the left ventricular function by longitudinal strain and Doppler analysis of the trans-mitral blood flow was performed at months 1, 6, 12. RESULTS The baseline systolic and diastolic blood pressures scores were 153.4 +/- 14.4/99.2 +/- 6.7 mmHg and 157.6 +/- 12.5/97.3 +/- 8.2 mmHg for males and females, respectively. The systolic and diastolic values at 1 month were 131.7 +/- 7.4/83.6 +/- 5.2 mmHg for males and 132.4 +/- 5.3/81.8 +/- 6.9 mmHg for females (p < 0.05 vs. baseline). The baseline E/E' was 6.5 +/- 0.9, E/A - 0.6 +/- 001, DT - 258 +/- 32.7 msec. These indicators at month 12 were as follows: E/E' - 7.0 +/- 0.64, E/A - 0.7 +/- 0.05, DT - 239 +/- 16.5 msec, p = NS. Baseline global longitudinal strain in males was -10.4 +/- 0.7% and -11.0 +/- 0.9% in females and at month 12 - 16.3 +/- 0.9% and -17.5 +/- 0.7% for males and females, respectively, p < 0.05. For the period of follow-up no adverse effects due to aliskiren treatment were registered. CONCLUSIONS Adding aliskiren to combined antihypertensive therapy leads to significant improvement of hypertension control and myocardial function assessed by global longitudinal strain.