Even short-term treatment with angiotensin converting enzyme inhibitor in essential hypertension has been known to improve left ventricular (LV) diastolic function, LV hypertrophy (LVH), and aortic stiffness. The purpose of this study was to examine the effects of angiotensin II receptor antagonist (Losartan) on LV diastolic function, LVH, and aortic stiffness in essential hypertension.

Twenty-three hypertensive patients who were aged over 50 years, previously untreated, and without cardiac, renal, neurologic disease, or diabetes, were studied. Before and 12 weeks after monotherapy with Losartan 50 mg q.d., (1) supine arterial blood pressure by sphygmomanometry, (2) interventricular septum and LV posterior wall thickness, and LV end-diastolic dimension by M-mode echocardiography, (3) mitral peak E and A wave velocity by doppler echocardiography, (4) pulse wave velocity (PWV) in the descending aorta from aortic arch to the bifurcation by doppler echocardiography, were done.

Twelve weeks after treatment, systolic blood pressure was lowered from 168.2±3.5 mmHg to 142.9±2.9 mmHg (p<0.05), diastolic blood pressure from 98.52.4 mmHg to 87.51.3 mmHg (p<0.05). Peak E/A ratio was increased from 0.75±0.04 to 0.82±0.04 (p<0.05). LV mass was decreased from 267.5±15.8 g to 235.6±12.6 g (p<0.05), and LV mass index from 166.8±8.0 g/m² to 146.9±6.0 g/m² (p<0.05). However, there were no significant change in PWV (from 7.18±0.10 m/sec to 7.23±0.30 m/sec, p>0.05), compliance (from 1.31±0.04 to 1.34±0.12, p>0.05), and compliance index (from 0.16±0.01 to 0.15±0.01, p>0.05).

Short-term treatment with Losartan decreases blood pressure, improves LV diastolic function and LVH, but not aortic stiffness.