Why the study?
Does the combination of felodipine and metoprolol improve regression of left ventricular hypertrophy compared to felodipine alone in hypertensive patients with LVH?
Does the combination of felodipine and metoprolol improve regression of left ventricular hypertrophy compared to felodipine alone in hypertensive patients with LVH?
Adding metoprolol to felodipine does not provide additional regression of left ventricular hypertrophy compared to felodipine alone when similar blood pressure control is achieved.
Adding metoprolol to felodipine yields no extra LVH regression when BP is equally lowered; confirms BP reduction as the dominant driver.
Seventy-six hypertensive patients with left ventricular hypertrophy (LVH) were randomized to receive felodipine or felodipine plus metoprolol in a double-blind parallel-group study. The doses of each treatment regimen were titrated to obtain a diastolic blood pressure (BP) of less than 95 mmHg. The duration of the treatment was 9 months. At the end of the study, BP was significantly reduced in both groups, and the reduction did not differ between the groups. Left ventricular posterior wall and septum thickness were significantly and similarly reduced in both groups. Left ventricular systolic and diastolic end diameters were not significantly changed. Left ventricular mass (LVM) was significantly and similarly reduced in both treatment groups, as was the ratio of LVM and left ventricular end diastolic volume. In conclusion, felodipine and the combination of felodipine and metoprolol reduced left ventricular hypertrophy to the same extent when BP was similarly reduced.
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Wetzchewald et al. (1992) studied this question.
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