The effects of ACEI and a low dose of spironolactone on the left ventricular remodeling and the turnover of myocardial collagen

Objective: To observe the effects on collagen turnover and the relationship between PⅢNP and remedy,PⅢNP and left ventricular remodeling by controlling the angiotensin II and aldosteron of RAAS under the premise of controlling blood pressure stably and efficiently. Methods: 135 patients with hypertension were observed for one year. All of them were divided into three groups randomly,including A （ACEI+spironolactone）, B （ACEI） and C （traditional remedy: intervention with routine therapeutics excluding the drugs effecting on RAAS） groups. The serum PⅢNP and the left ventricular weight index （LVWI） were compared before and after the therapy. Results: Under the same blood pressure controlling precondition,the remedy of a low dose of spironolactone along with ACEI can decrease serum PⅢNP and LVWI much more. The remedy of ACEI with a low dose of spironolactone is correlated with the decrease of serum PⅢNP and LVWI. Conclusion: The remedy of a low dose of spironolactone along with ACEI is better in the decreasing of serum PⅢNP,the myocardial interstitial collagen deposition,and the left ventricular remodeling than ACEI remedy and traditional remedy. This effect is independent on blood pressure control.