Universidade Federal do Espírito Santo- Vitória. Supported by Projeto Capes/

Objective- To compare the regression of left ventricu-lar hypertrophy in patients with moderate hypertension treated with enalapril, losartan or a combination of the two drugs at lower doses. Methods- Patients of both sexes with moderate hy-pertension confirmed by ambulatory monitoring of arte-rial blood pressure and with left ventricular hypertrophy on echocardiogram were assigned to three groups: enalapril (35 mg/day, n=15), losartan (175 mg/day, n=15) and enalapril+losartan (15 mg+100 mg/day, n=16). The patients received the drugs for 10 months. Results- The three therapeutic regimens were equal-ly effective in reducing blood pressure and left ventricular mass index (LVMI, g/m2): 141±3.9 to 123±3.6 in the enala-pril group (p<0.05), from 147±3.8 to 133±2.8 in the losar-tan group (p<0.05), and from 146±3.0 to 116±4.0 in the enalapril+losartan group (p<0.05). However, the percent reduction of LVMI was significantly greater (p<0.01) in the enalapril+losartan group (20.5±5.0%) than in ena-lapril (12.4±3.2%) and the losartan (9.1±2.1%) groups. Normalization of LVMI was obtained in 10 out of the 16 patients who received enalapril+ losartan, in 6 out of the 15 patients who received only enalapril and in 4 out of the 15 patients treated with losartan. Conclusion- The combination of an angiotensin-con-verting enzyme inhibitor and an angiotensin II receptor antagonist (AT1 receptor antagonist) in patients produced an additional effect on the reduction of left ventricular hypertrophy. This finding may depend on a more complete inhibition of the cardiac renin-angiotensin. Key words: hypertension, cardiac hypertrophy, angio-tensin-converting enzyme, losartan, renin