P-115: AT1 receptor blocker and diuretics in the treatment of arterial hypertension: hemodynamic differences

• Published in: American journal of hypertension 2002-04, Vol.15 (S3), p.72A-72A
• Main Authors: Delgado, Antonio J., Delgado-Almeida, Antonio R., Celis, Susana I., Delgado-León, Carlos L., Galves, Elymir S., Rupo, Doriana Di
• Format: Article
• Language: English
• Subjects: Amiloride; Arterial Waveform Analysis; Telmisartan
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(02)02466-4

LVMF BP recordings stand for the basic approach in the assessment of clinical course of Hypertension. The assessment of Left Ventricular MyocardialFunction () and Vascular Parameters (VP) enables us to study how these characteristics are modified with drugs interventions. Aim: To determinate the effects of an AT1 receptor blocker: Telmisartan (Tl), and a diuretic: Amiloride (Am) in LVMF and VP. Methods: 33 hypertensives subjects (BP ≥ 140/90 mm Hg) enter in the study (Male n=13, Female n=20), age 54.3±12.7 yrs.: Group Tl (40 mgr/d) n=19, Group Am (5 mgr/d) n=14. BP measurements, LVMF 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. LVMF: Group Tl show improvement in After Load (AL) (1.8±0.3 to 1.5±0.4 mmHg/ml, p=0.00), dP/dTmax (1449±345 to 1128±247 mmHg/s, p=0.00), dP/dt DP 40 (36.2±8.6 to 28.2±6.2 s-1, p=0.00), and Stroke Work (SW) (89.6±1 9.5 to 69.0±14.6 J/m2/min, p=0.00) and Cardiac work (73.8±13.1 to 59.1±8.9 J/min, p=0.00). Group Am show improvement in dP/dTmax (1358±223 to 1110±246 mmHg/s, p=0.00), dP/dt DP 40 (33.9±5.6 to 27.7±6.1 s-1, p=0.00), and SW (72.6±16.3 to 63.3±16.3 J/m2/min, p=0.00) and Cardiac work (70.0±14.6 to 60.6±17.3 J/min, p=0.00); no effect on AL. No change on LVSV or CO was observed in both groups. VP: Group Tl show reduction in Systemic Vascular Resistance (SVR) (1826±275 to 1478±252 dine.s.cm-5, p=0.00); improvement in SV Compliance (1.065±0.28 to 1.415+0.4 ml/mmHg, p=0.00). Group Am tended to show a reduction in SVR (1756±349 to 1615±460 dine.s.cm-5, p=0.06) with no statistical significance; Compliance (1.088±0.36 to 1.420±0.42 ml/mmHg, p=0.00) was improved. Conclusion: Despite that both drugs show reduction in BP parameters, there are hemodynamic differences: Tl improve After Load and Contractility index, reducing SVR and increasing Vascular Compliance, whereas Am only show improvements in contractility index, and increasing Vascular compliance, without significant effect in SVR.