Source: Endocrine  |  Posted 9 years ago

Irbesartan, an angiotensin II type 1-receptor blocker, reduces cardiac repolarization heterogeneity in hypertensive patients with left ventricular hypertrophy.

Results are from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation Versus Atenolol (SILVHIA) and are reported by investigators from the Karolinska Institute in Stockholm, Sweden.

Forty-four patients received irbesartan and 48 patients received atenolol for a period of 48 weeks.

Repeat echocardiography and evaluation of QT dispersal, a reflection of cardiac repolarization heterogeneity, were performed on all patients and on 37 matched hypertensive controls without left ventricular hypertrophy.

Left ventricular mass was found to be related to QT dispersal. Patients in the irbesartan group showed a greater reduction in left ventricular mass and in blood pressure than patients in the atenolol group.

Decreases in QT and QTc dispersions were seen in the irbesartan group, but only minor effects were observed in the atenolol group.

Multivariate analysis showed that the reductions in QT and QTc dispersions observed in the irbesartan group were independent of changes in left ventricular mass, blood pressure or heart rate.

Irbesartan appears to induce structural and electrical remodeling, the investigators conclude. These changes could lower the risk of fatal events in hypertensive patients, they suggest.

Funding for this study was provided by the Swedish Heart-Lung Foundation, Karolinska Institute in Stockholm, Sweden, by Bristol-Myers Squibb Pharmaceutical Research Institute in Princeton New Jersey, United States and by Sanofi-Synth