Effects of Telmisartan-based Therapy on Left Ventricular Hypertrophy and Left Ventricular Function in Patients with Essential Hypertension

Objective To evaluate the effects of Telmisartan-based therapy on left ventricular hypertrophy and left ventricular function in patients with essential hypertension.Methods Untreated patients with simple essential hypertension were given Telmisartan-based(80 mg/d) therapy.When the blood pressures stepped down to normal standard,237 patients were diagnosed with left ventricular hypertrophy by echocardiography.Among them,195 patients were ruled out because of other coexisted diseases,of which were excluded out of coronary heart disease,the ratio was 69.74% of all the excluded cases.The 41 left patients were simple essential hypertension with left ventricular hypertrophy(17.30%),which were the final observed targets.The changes of left ventricular hypertrophy and left ventricular function were checked and recorded by echocardiography after 1 year.Results 1.The blood pressure extent of simple essential hypertension with left ventricular hypertrophy was quite high: the systolic pressure was(189.21±19.91) mmHg,the diastolic pressure was(101.40±16.92) mmHg;2.Telmisartan-based therapy was effective for the treatment of essential hypertension,the efficient ratio of monotelmisartan was 17.07%;3.Afer 1-year-treatment,the interventricular septum(IVS),diastolic left ventricular posterior wall thickness(LVPW),left ventricular massiveness(LVM),left ventricular massiveness index(LVMI) reduced sharply(P 0.01),the ejection fraction(EF) was elevated(P 0.05),the left ventricular hypertrophy was reversed and the left ventricular systolic function was improved;4.the inside diameter of left atrium(LA) had no changes;5.Pre-treatment,the ratio of E/A,indicating the left ventricular diastolic function,was declined(the ratio of E/A was 0.97±0.38),the left ventricular diastolic function dropped down even more seriously(P 0.05) 1-year later,the declining trend of left ventricular diastolic function maintain the same.Conclusion Patients of hypertension with left ventricular hypertrophy usually suffered with other diseases at the same time,coronary heart disease causes the highest mobility;essential hypertension with left ventricular hypertrophy is induced by increasing after load of left ventricle;Telmisartan is an antagonist of AT1 receptor,it can not only effectively reduce the high blood pressure,but also reverse left ventricular hypertrophy and improve the left ventricular systolic function.However,it has no effect on reversing the cardiac muscle fibrosis and the left ventricular diastolic function.