Rapid Response

Blood Pressure Reduction Is More Important than Renin-Angiotensin System Blockade to Improve Diastolic Function

Authors: Walter A. Brzezinski, MD, Jan Basile, MD

Abstract

Diastolic dysfunction occurs in up to 50% of patients with hypertension. Characterized by abnormalities of left ventricular (LV) filling, it is often associated with clinical heart failure. Antihypertensive agents that inhibit the renin–angiotensin-system (RAS) have been shown to improve diastolic function, but whether this is related to their blood pressure (BP)-lowering effect or another unique action independent of BP reduction remains unclear. The Valsartan in Diastolic Dysfunction (VALIDD) study, an industry-sponsored study by the maker of valsartan, sought to determine whether lowering BP with the angiotensin receptor blocker (ARB) valsartan would improve diastolic function to a greater extent than non-RAS antihypertensive therapy.

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References

1. Solomon S, Janardhanan R, Verma A, et al. Effect of angiotensin receptor blockade and antihypertensive drugs on diastolic function in patients with hypertension and diastolic dysfunction: a randomized trial. Lancet 2007;269:2079–2087.