Effects of ACE inhibitors versus calcium antagonists on left ventricular morphology and function in patients with essential hypertension.

We compared the effects of two long-term antihypertensive treatments (ACE inhibitors vs. Ca antagonists) on left ventricular hypertrophy (LVH) and LV function in patients with essential hypertension and LVH. After a washout period of at least 4 wk, ceronapril or delapril was administered to 18 patients and nifedipine or nicardipine to 15 patients for 6 months. Mean blood pressure (MBP), LV mass (LVM), LV fractional shortening (FS), systolic time intervals (ejection time/pre-ejection period ratio = ET/PEP), and isovolumic relaxation time (IRT) were examined in the pretreatment phase and after 6 months of treatment. MBP and LVM significantly and similarly decreased after treatment in both groups (ACE inhibitors vs. Ca antagonists, delta MBP: -17.1 +/- 1.3 vs. -16.9 +/- 1.6%; delta LVM: -11.7 +/- 2.7 vs. -10.0 +/- 3.8%, both p = not significant). ACE inhibitors produced significant beneficial changes in FS, ET/PEP, and IRT after treatment as compared with Ca antagonists (ACE inhibitors vs. Ca antagonists, delta FS: 11.8 +/- 3.3 vs. 5.1 +/- 4.1%, p < 0.05; delta ET/PEP: 11.9 +/- 2.3 vs. 4.7 +/- 6.4%, p < 0.05; delta IRT: -12.0 +/- 3.4 vs. -3.8 +/- 6.1%, p < 0.05). The results indicate that both ACE inhibitors and Ca antagonists induce significant and similar reductions in blood pressure and LVM in hypertensive patients. ACE inhibitors produce significant improvements in LV function in both systolic and diastolic phases as compared with Ca antagonists.