P-114: Hemodynamic differences among AT1 receptor blockers in arterial hypertension: results with valsartan and telmisartan

• Published in: American journal of hypertension 2002-04, Vol.15 (S3), p.72A-72A
• Main Authors: Celis, Susana I., Delgado, Antonio J., Galves, Elymir S., Delgado-León, Carlos L., Delgado-Almeida, Antonio R.
• Format: Article
• Language: English
• Subjects: Arterial Waveform Analysis; Telmisartan; Valsartan
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(02)02465-2

LVF The assessment of hemodynamic parameters (Left Ventricular Function () and Vascular Parameters (VP)) enables us to evaluate different effects of drugs interventions on these parameters. Aim: To determinate the hemodynamic effects of AT1 receptor blocker: Telmisartan (Te) vs Valsartan (Va) on LVF and VP. Methods: 40 hypertensives subjects (BP ≥ 140/90 mm Hg) enter in the study (Male n=16, Female n=24): Group Te (40 mgr/d) n=22, 55.3±9.6 yrs.; Group Va (80 mgr/d) n=18, 52.9±13.2 yrs. BP measurements, LVF and VP recordings were obtained with a DynaPulse 200M (PulseMetric), at basal and 4 weeks of treatment. Paired T-test was performed, with statistical significance α=0.05. Results: After the treatment there was a reduction in both groups; no effects on Pulse. LVF: Group Te show improvement in After Load (AL) (1.8±0.4 to 1.5±0.4 mmHg/ml, p=0.00), dP/dTmax (1382±364 to 1112±251 mmHg/s, p=0.00), dP/dt DP 40 (34.5±9.1 to 27.8±6.2 s-1, p=0.00), and Stroke Work (SW) (89.9±20.8 to 68.1±14.1 J/m2/min, p=0.00) and Cardiac work (73.5±12.7 to 59.3±9.1 J/min, p=0.00). Group Va show improvement in dP/dTmax (1284±282 to 1105±257, p=0.000), dP/dt DP 40 (32±7 to 27±6, p=0.000), and SW (74.9±25.5 to 60.2±19.7, p=0.004) and Cardiac work (71.4±21.5 to 58.3±17.7, p=0.001); no effect on AL. No change on LVSV or CO was observed in both groups. VP: Group Te show reduction in Systemic Vascular Resistance (SVR) (1800±273 to 1486±251 dine.s.cm-5, p=0.00); improvement in SV Compliance (1.1±0.3 to 1.4±0.4 ml/mmHg, p=0.00). Group Va show reduction in SVR (1823±840 to 1553±482, p=0.045) with nearly statistical significance; SV Compliance (1.127±0.429 to 1.355±0.520, p=0.02) was increased. Conclusion: Despite that both drugs acts on RAS and show reduction in BP parameters, there are hemodynamic differences: Te improve After Load and Contractility index, reducing SVR and increasing Vascular Compliance, whereas Va only show improvements in contractility index, and increasing Vascular compliance, tending to decrease SVR and no effect in After Load.