Left ventricular mass and mechanics in mild-to-moderate hypertension: effect of nebivolol versus telmisartan.

BACKGROUND The aim of this study was to compare the effects of nebivolol and telmisartan on left ventricular mass (LVM) and midwall mechanics in mild-to-moderate hypertension. METHODS A total of 40 patients with mild-to-moderate hypertension were randomized to receive either nebivolol (2.5 to 5.0 mg/day) or telmisartan (40 to 80 mg/day) to achieve a target diastolic blood pressure of <90 mm Hg. Blood pressure (BP) was measured with sphygmomanometry, and LVM and midwall fractional shortening (mFS) were estimated by two-dimensionally guided M-mode echocardiography at baseline and at 3-month follow-up. RESULTS Age, sex distribution, and baseline SBP and DBP and heart rate were similar in the two groups. Both nebivolol and telmisartan reduced systolic (156 +/- 7 v 124 +/- 8 mm Hg, P < .01, and 153 +/- 5 v 120 +/- 7 mm Hg, P < .01, respectively) and DBP (99 +/- 4 v 80 +/- 2 mm Hg, P < .01 and 98 +/- 2 v 80 +/-2 mm Hg, P < .01, respectively) and increased mFS (16% +/- 2% v 19% +/- 2%, P < .01, and 15% +/- 2% v 18% +/- 2%, P < .01, respectively). The LVM indices decreased significantly with both nebivolol (98 +/- 16 v 84 +/- 13 g/m(2), P < .01) and telmisartan (97 +/- 13 v 83 +/- 8 g/m(2), P < .01). We found that mFS was inversely related to DBP in the nebivolol but not in the telmisartan group. CONCLUSIONS In mild-to-moderate hypertension, nebivolol and telmisartan are equally effective in reducing BP and increasing mFS. There may be differences between nebivolol and telmisartan regarding the mechanism of increase in mFS.