Περίληψη:
The effect of antihypertensive therapy on arrhythmias is controversial.
An initial study in patients with chronic heart failure indicated that
losartan, an angiotensin 11 receptor antagonist, may possess
antiarrhythmic properties. However, the effect of AT1 receptor
antagonists on arrhythmias of subjects with good systolic function has
never been evaluated. Thirty-nine men with primary hypertension (18
without left ventricular hypertrophy [LVH], and 21 with LVH, aged 48.2
+/- 8.6 and 50.5 +/- 6.0 years, respectively), 15 healthy normotensive
subjects (47.9 +/- 8.5 years), and 14 highly trained athletes (34.1 +/-
1.6 years) were studied. Transthoracic echocardiography and 24-hour
Holter ambulatory monitoring were performed at baseline (without
treatment). Hypertensive patients underwent the same examinations after
8 months of losartan administration. The prevalence and complexity of
ventricular arrhythmias, and the frequency of supraventricular
arrhythmias were increased in hypertensive patients with LVH compared to
normotensive controls and athletes, at baseline. A similar significant
reduction of blood pressure (BID) was noted in both groups of patients
(p < 0,001). The LVH was reduced in hypertensives with LVH (the left
ventricular mass index by 12%, the interventricular septum by 8.1%,
the posterior wall by 7%, all p < 0.01). However, the arrhythmias did
not change in either group of patients, even if all hypertensives were
considered as 1 group. In conclusion, an 8-month course with losartan
was effective in lowering BP and reducing LVH. However, the increased
arrhythmias, which were registered in hypertensive patients with LVH at
baseline, did not change.
Συγγραφείς:
Zakynthinos, E
Pierrutsakos, C
Daniil, Z
Papadogiannis, D
