Abstract

For contrasting the effects of Losartan, Fosinopril and Nifedipe GITS on ambulatory blood pressure (ABP), cardiac structure and function, and protective function of endothelium in patients with essential hypertension (EH), eighty-seven patients with mild to moderate EH were studied. Patients with EH were randomly divided into three groups and were treated with Nifedipine GITS 30mg/d (n=29), Fosinopril 10mg/d (n=28) or Losartan 50mg/d (n=30) separately. The Changes of ABP and plasma levels of ET, NO, GMP140, vWF were compared before and after 4-weeks treatment. Plasma levels of endothelin (ET), nitric oxide(NO), von Willebrand Factor (vWF), plate-granule membrane protein (GMP140) were measured with radioimmunoassay, enzymatic assay or ELISA as indexes of endothelial functions. Cardiac structure and function were measured with echocardiography before and after treatments of 4 and 16 weeks. Side effect was 18.2% in L, 39.4% in F and 43.8% in N group. The regression in F group was largest and that in N group was smallest. Nifediping GITS is supperior to the others in T/P ratio and GMP140, Fosinopril and Losartan is supperior to Nifediping GITS in reversing ventricular hypertrophy, it was suggested that the effects of reversing ventricular hypertrophy was not only rely on the reduced blood pressure. Losartan is supper to the others in drug tolerance.

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