Comparison of valsartan or cilazapril in treatment of elderly patients with isolated systolic hypertension

Objective: To study clinical efficacy, effect on metabolism and left ventricular hypertrophy (LVH)of valsartan or cilazapril combined with low-dose hydrochlorothiazide respectively in treating elderly patients with isolated systolic hypertension(ISH). Methods: Sixty-eight patients were divided randomly into two groups: 34 cases in valsartan group and 34 cases in cilazapril group, valsartan 80-160 mg/d plus hydrochlorothiazide 12. 5 mg/d or cilazapril 2. 5-5 mg/d plus hydrochlorothiazide 12. 5 mg/d were given to patients in the two groups respectively. 24 hour ambulatory blood pressure monitoring (24h-ABPM), color echocardiography, serum metabolic parameters were evaluated before and after 6 months drug therapy and compared between the two groups. Results: (1) Side effects: stomach unwell (two cases, 6. 06%) and dizzy (one case, 3. 03%) occured in valsartan group, a dry cough (six cases, 17. 65%) occured in cilazapril group. (2) The mean systolic blood pressure of 24 h, daytime and nighttime were lowered apparently after treatment compared with pretreatment in both groups (P 0. 01). The parameters of 24h-AB-PM after treatment were not statistically significant between the two groups (P 0. 05). (3) The mean heart rate changes were not statistically significant before and after 6 months drug therapy in both groups (P0. 05). (4) The left ventricular mass index(LVMI) reduced significantly after treatment compared with pretreatment in both groups (P 0. 01). The parameters of color echocardiography after treatment were not statistically significant between the two groups (P 0. 05). (5) The changes of metabolic parameters such as serum K+ , fasting blood glucose (FBG), serum creatinine(SCr), uric acid(UA), total cho-lesterol(TC) , triglyceride(TG) , were not observed in both groups before and after treatment (P 0. 05). Conclusions: Valsartan or cilazapril combined with low-dose hydrochlorothiazide respectively in either case can lower effectively the SBP level in treating elderly patients with ISH and make left ventricular hypertrophy dispelled.