Regression of cardiac hypertrophy in type 2 diabetes with hypertension by candesartan

This study was designed to compare the effect of candesartan on cardiac left ventricular mass in Japanese patients with that of amlodipine. A total of 40 type 2 diabetic patients with hypertension and left ventricular hypertrophy (LVH) were randomly assigned to receive candesartan (n = 20) or amlodipine (n = 20). The two treatments when administered for 6 months significantly reduced systolic and diastolic blood pressures (BPs) to a comparable extent. Notably, candesartan significantly reduced left ventricular mass index (LVMI: from 131.5 ± 4.5 to 112.1 ± 5.9 g/m2, P = 0.0009, M ± S.E.M.), LV posterior wall thickness (PWTd: from 10.3 ± 0.3 to 9.1 ± 0.3 mm, P = 0.0052) and interventricular septal thickness (IVSTd: from 10.7 ± 0.4 to 9.3 ± 0.4 mm, P = 0.0019) as determined by echocardiography in diastole, but amlodipine treatment did not. LVMI, PWTd and IVSTd were decreased more significantly by the treatment with candesartan than by that with amlodipine (P = 0.020, 0.031 and 0.043). The present study thus revealed that candesartan effectively induced regression of LVH in type 2 diabetic patients with hypertension due to effects beyond reduction in BP.