Effects of combined treatment with perindopril and candesartan on essential hypertension patients with left vertricular and carotid arterial remodeling

Objective To examine the effects of combined treatment with perindopril and candesartan on essential hypertension(EH)patients with left vcntricular hypertrophy(LVH) and carotid arterial remodeling.Methods A total of l42 EH patients with LVH were divided randomly into three groups:perindopril group received perindopril 4mg per day,candesartan group received candisartan 4mg per day,combined treatment group received perindopril 4mg and candisartan 4mg per da.All groups received dihydrochiorothiazide(DHCT) 25mg per day.If patients'SBP still≥l40mm Hg or DBP≥90mm Hg in the next four weeks.the dose of perindopril or candesartan would be increased to tiwce as belore until BP fell to the normal base level(SBP140mm Hg and DBP90mm Hg).The entire treatment would last for 36weeks.The 24hour ambulatory blood pressure monitoring(ABPM),heart rate(HR),left ventricular enddiastolic dimension(LVDd),left ventricular spetal(IVST),left ventricular enddiastolic wall thickness(LVPWT),left ventricular mass index(LVMI),cardiothoracic ratio(CTR),intimamedia thickness(IMT)and inner diameter(ID) of common carotid artery(CCA),internal carotid artery(ICA) were examined before and after treatment for confirmming the efficacy of medication.Results(1)The 24h SBP an d 24h DBP of patients in three groups decreased significantly after treatment(all P0.05),but there is not markedly difference in decreasing amplitude among the three groups(all P0.05).(2)LVDd,IVST,LVPWT,LVMI,HR,CTR,IMT,ID,IMT/ID of patients in three groups decreased or improved significantly after treatment(P0.05 or 0.01).and the decreasing or improving amplitude of LVDd,LVMI,HR,CTR,IMT,IMT/ID of patients in combined treatment group were markedly higher than those of the other two groups(P0.05 or P0.01).Conclusion Combined treatment with perindoril and candesartan has more intensive effect on reversing LVH,inhibiting sympathetic activity and carotid arterial remodeling,comparing with single drug treatment.Above effects are independent of blood pressure depressing.