TY - JOUR
T1 - Effect of Losartan and Hydrochlorothiazide on Exercise Tolerance in Exertional Hypertension and Left Ventricular Diastolic Dysfunction
AU - Little, William C.
AU - Zile, Michael R.
AU - Klein, Allan
AU - Appleton, Christopher P.
AU - Kitzman, Dalane W.
AU - Wesley-Farrington, Deborah J.
N1 - Funding Information:
This study was supported in part by an unrestricted grant from Merck and Company, Inc., West Point, Pennsylvania; Grant AG18915 from the National Institute on Aging, Bethesda, Maryland; and Grant M01-RR07122 from the Wake Forest University General Clinical Research Center, Winston-Salem, North Carolina.
PY - 2006/8/1
Y1 - 2006/8/1
N2 - A randomized, double-blind study of 6 months of losartan 50 mg or hydrochlorothiazide (HCTZ) 12.5 mg was performed in 40 subjects with left ventricular diastolic dysfunction (mitral flow velocity E/A ratio <1), exercise systolic blood pressure (BP) >200 mm Hg, systolic BP at rest <150 mm Hg, ejection fraction >50%, and no ischemia. Before treatment, exercise systolic BP was 213 ± 13 mm Hg (mean ± SD) in the 19 patients randomized to losartan and 209 ± 11 mm Hg in the 21 patients who received HCTZ. After 6 months, exercise systolic BP was similarly reduced in patients who received losartan (197 ± 23 mm Hg, p <0.01) and HCTZ (191 ± 11 mm Hg, p <0.01). With losartan, treadmill exercise time increased from 894 ± 216 to 951 ± 225 seconds (p = 0.011), and quality of life improved from 15 ± 12 to 7 ± 10 (p = 0.015) without a change in oxygen consumption (1,895 ± 470 to 1,954 ± 539 ml/min, p = 0.30). With HCTZ, exercise time (842 ± 225 to 872 ± 239 seconds, p = 0.32) and quality of life (19 ± 21 vs 19 ± 24, p = 0.43) did not change, whereas oxygen consumption decreased from 2,144 ± 788 to 1,960 ± 706 ml/min (p = 0.022). In conclusion, in patients with diastolic dysfunction and hypertensive responses to exercise, 6 months of losartan and HCTZ blunted systolic BP during exercise. Only losartan increased exercise tolerance and improved quality of life.
AB - A randomized, double-blind study of 6 months of losartan 50 mg or hydrochlorothiazide (HCTZ) 12.5 mg was performed in 40 subjects with left ventricular diastolic dysfunction (mitral flow velocity E/A ratio <1), exercise systolic blood pressure (BP) >200 mm Hg, systolic BP at rest <150 mm Hg, ejection fraction >50%, and no ischemia. Before treatment, exercise systolic BP was 213 ± 13 mm Hg (mean ± SD) in the 19 patients randomized to losartan and 209 ± 11 mm Hg in the 21 patients who received HCTZ. After 6 months, exercise systolic BP was similarly reduced in patients who received losartan (197 ± 23 mm Hg, p <0.01) and HCTZ (191 ± 11 mm Hg, p <0.01). With losartan, treadmill exercise time increased from 894 ± 216 to 951 ± 225 seconds (p = 0.011), and quality of life improved from 15 ± 12 to 7 ± 10 (p = 0.015) without a change in oxygen consumption (1,895 ± 470 to 1,954 ± 539 ml/min, p = 0.30). With HCTZ, exercise time (842 ± 225 to 872 ± 239 seconds, p = 0.32) and quality of life (19 ± 21 vs 19 ± 24, p = 0.43) did not change, whereas oxygen consumption decreased from 2,144 ± 788 to 1,960 ± 706 ml/min (p = 0.022). In conclusion, in patients with diastolic dysfunction and hypertensive responses to exercise, 6 months of losartan and HCTZ blunted systolic BP during exercise. Only losartan increased exercise tolerance and improved quality of life.
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U2 - 10.1016/j.amjcard.2006.01.106
DO - 10.1016/j.amjcard.2006.01.106
M3 - Article
C2 - 16860028
AN - SCOPUS:33746178479
SN - 0002-9149
VL - 98
SP - 383
EP - 385
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 3
ER -