Perindopril plus losartan can reverse left ventricular hypertrophy in patients with essential hypertension.

Objective To investigate the effects of perindopril and losartan used separately or in combination on reversing left ventricular hypertrophy(LVH) in patients with essential hypertension(EH).Methods Ninety patients with EH were randomly assigned to receice perindopril(4 mg qd,n=30),losartan(50 mg qd,n=30) or combined treatment(perindopril 4 mg qd plus losartan 50 mg qd,n=30) for 24 weeks.If BP remained ≥160/100 mmHg after 4 weeks' treatment,the doses of perindopril and losartan doubled.Left ventricular mass index(LVMI) was measured by colour doppler echocardiography before and after treatment.Blood pressure was recorded by means of ambulatory blood pressure monitoring(ABPM).Results ①At 24 weeks,LVMI was significantly decreased in all three groups as compared with baseline values(all P0.01).The reduction in LVMI was significantly greater in combined treatment group than that in the other two groups(all P0.01),but the differences in reduction of LVMI were not significant between perindopril group and losartan group(P0.05).②Before treatment,mean 24 h systolic blood pressure(SBP) and mean 24 h diastolic blood pressure(DBP) were not significantly different among three groups(all P0.05).At 24 weeks,mean 24 h SBP and mean 24 h DBP were significantly decreased in all three groups as compared with baseline values(all P0.01),but these values were not significantly different among three groups(all P0.05).Conclusion Both perindopril and losartan can reverse LVH in patients with EH,this effect is increased when the two drugs are used together,and this additive effect is not related to their antihypertensive effect.