Antihypertensive effect of bisoprolol in middle. aged hypertension patients with left ventricular hypertrophy

  Objective  To evaluate the effect of bisoprolol-based therapy on hypertension and left ventricular hypertrophy in middle-aged hypertension patients with left ventricular hypertrophy.

  Methods  Using stratified random sampling, we recruited 45 – 60 years old hypertension patients complicated with left ventricular hypertrophy and hospitalized in a hospital in Nantong city of Jiangsu province and then divided them into two groups according to their medication regimen: group A (bisoprolol or plus amlodipine, n = 483) and group B (losartan or plus amlodipine, n = 506). Disparities in changes of blood pressure, left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), early diastolic transmitral velocity/late diastolic transmitral velocity (E/A), and early diastolic tissue velocity/late diastolic tissue velocity (Em/Am) before and after the medication were compared between the two groups.

  Results  For the patients of group A, the systolic blood pressure (SBP) decreased significantly from 162.6 ± 15.7 mmHg to 134.8 ± 13.4 mmHg and the diastolic blood pressure (DBP) decreased significantly from 95.8 ± 14.6 mmHg to 85.7 ± 8.2 mmHg after the medication (both P < 0.001); while, for the patients of group B, the SBP also decreased from 165.5 ± 18.9 mmHg to 136.7 ± 16.2 mmHg and the DBP decreased from 97.4 ± 17.3 mmHg to 83.5 ± 8.7 mmHg after the medication, with significant differences (both P < 0.001). But there was no significant differences in blood pressure between the two groups before and after the medication. Compared to those before the medication, the E/A value increased significantly from 0.70 ± 0.19 to 0.87 ± 0.15 for the patients of group A (P = 0.01) and from 0.73 ± 0.18 to 0.86 ± 0.14 for the patients of group B (P = 0.03) after the medication; the Em/Am value also significantly increased from 0.59 ± 0.14 to 0.77 ± 0.16 for the patients of group A (P = 0.01) and 0.63 ± 0.15 to 0.79 ± 0.13 for the patients of group B (P = 0.02) after the medication. There were no significant differences in E/A and Em/Am value between the two groups before and after the medication. Insignificant upward trend in LVEF and downward trend in LVMI were observed.

  Conclusion  There is no statistically significant difference between therapeutic effect of bisoprolol-based and losartan-based medication regimen on left ventricular hypertrophy in middle-aged hypertension patients and the two regimens could be used as alternatives for each other among the patients.