A Comparative Evaluation of Losartan/ Hydrochlorothiazide (Fixed Combination) versus Amlodipine Monotherapy on Left Ventricular Hypertrophy, Biochemical Parameters and Adverse Effects in Patients of Hypertension.

ABSTRACT

Background: Long-term administration of antihypertensives require better efficacy and tolerability. Moreover, the agent should regress left ventricular hypertrophy (LVH), which is an important predictor of cardiovascular events. Aims: To comparatively evaluate the effects of losartan/hydrochlorothiazide (LST/HCTZ) and amlodipine (AMLO) on LVH, biochemical parameters and adverse effects in hypertension. Material and methods: Two hundred fifty newly diagnosed hypertensive patients were randomly divided into two groups. LST 50 mg/HCTZ 12.5 mg and AMLO 5 mg once-daily, were administered. Biochemical parameters, adverse effects and ECG were recorded initially and after 6 months of therapy. Statistical analysis was done. Results: Both regimens significantly reduced mean SBP and DBP in each of the six follow ups (p < 0.001). LST/HCTZ caused regression of LVH in greater number of cases (26) than AMLO (20) and also showed a significant increase in mean values of serum creatinine, serum uric acid and high-density lipoprotein (HDL) levels and a significant decrease in Serum cholesterol. In AMLO group only serum creatinine was raised. The most common adverse effects in LST/HCTZ was dizziness (4.5%) and in AMLO group pedal edema (22%). Conclusion: Comparatively LST/HCTZ therapy causes regression of LVH in larger number of cases, increases HDL and is better tolerated.