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Diastolic dysfunction may be an important intermediate stage between hypertension and heart failure. Angiotensin-receptor blockers (ARBs) have been shown to be superior to other antihypertensive drugs at reducing LV hypertrophy; might ARBs have a superior effect on diastolic dysfunction as well?
In a manufacturer-sponsored, multicenter trial, 384 patients (mean age, 60; 50% female) with mild hypertension and evidence of diastolic dysfunction were randomly assigned to receive valsartan (force-titrated beyond the blood pressure goal to a maximum dose of 320 mg once daily) or placebo. Less than 3% of patients had LV hypertrophy. Patients in both groups also received antihypertensive agents that did not inhibit the renin-angiotensin-aldosterone …