What does this research mean for the field?

Both the calcium antagonist isradipine and the ACE inhibitor perindopril reduce left ventricular hypertrophy and improve diastolic function in hypertensive patients, but perindopril induces a greater reduction in LV mass that appears partly independent of blood pressure decreases. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare the effects of 6-month treatment with isradipine versus perindopril on 24-hour ambulatory blood pressure and left ventricular hypertrophy in hypertensive patients.

November 1, 1995Journal of Cardiovascular Pharmacology

Ambulatory Blood Pressure and Left Ventricular Changes During Antihypertensive Treatment

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Why the study?

Does perindopril compared to sustained-release isradipine improve left ventricular hypertrophy and blood pressure in hypertensive patients with LV hypertrophy?

Population

36 hypertensive patients with left ventricular (LV) hypertrophy

Comparison

Perindopril for 6 months vs Sustained-release isradipine for 6 months

Design

Cohort

Follow-up

6 months

Authors

AGAnna Maria GrandiUNSW Sydney MBMassimo BignottiUniversity of Pavia GGGiovanni GaudioUniversity of Insubria

Discussion

Member takes

Implication

Perindopril may confer greater LV mass reduction than isradipine in hypertensive LVH; hypothesis-generating and should not yet change practice.

Key Points

To compare the effects of 6-month treatment with isradipine versus perindopril on 24-hour ambulatory blood pressure and left ventricular hypertrophy in hypertensive patients.
Assessed 36 hypertensive patients with left ventricular hypertrophy allocated to 6 months of treatment with sustained-release isradipine (n=18) or perindopril (n=18).
Evaluated left ventricular mass, dimensions, and diastolic filling rates using digitized M-mode echocardiography alongside 24-hour ambulatory blood pressure monitoring at baseline and after treatment.
Both treatments produced comparable, significant reductions in 24-hour, daytime, and nighttime systolic and diastolic blood pressure.
Reduction in left ventricular mass index was significantly greater in the perindopril group compared to the isradipine group (p < 0.01).
Left ventricular mass reduction correlated with 24-hour and daytime blood pressure reductions only in the isradipine group, while isradipine induced a significantly greater increase in peak lengthening rate of left ventricular diameter (p < 0.01).

Structured PICO

Does perindopril compared to sustained-release isradipine improve left ventricular hypertrophy and blood pressure in hypertensive patients with LV hypertrophy?

Population

36 hypertensive patients with left ventricular (LV) hypertrophy

Intervention

Perindopril for 6 months

Comparator

Sustained-release isradipine for 6 months

Outcome

Changes in left ventricle (LV mass index, peak lengthening rate of LV diameter) and 24-h ambulatory blood pressure (SBP, DBP) at 6 monthssurrogate

Perindopril and isradipine both effectively lower blood pressure and improve diastolic function in hypertensive patients with LV hypertrophy, but perindopril provides a greater reduction in LV mass index that appears partly independent of blood pressure lowering.

Cite This Study

Grandi et al. (1995) studied this question.

synapsesocial.com/papers/6a14a71a6667a4fa718ef5c9 https://doi.org/10.1097/00005344-199511000-00010

Topics

Hypertension management

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Implication

Perindopril may confer greater LV mass reduction than isradipine in hypertensive LVH; hypothesis-generating and should not yet change practice.

Ambulatory Blood Pressure and Left Ventricular Changes During Antihypertensive Treatment

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Ambulatory Blood Pressure and Left Ventricular Changes During Antihypertensive Treatment

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider