Antihypertensive therapy has greater impact on left ventricular hypertrophy reduction in women than men: the life study

Whether change in systemic hemodynamics due to antihypertensive therapy effects regression of LV hypertrophy (LVH) differently in women and men remains unclear. Paired echocardiograms were available in 733 subjects with Stage I-III hypertension and ECG LVH (Cornell voltage duration criteria or modified Sokolow-Lyon voltage criteria) enrolled in the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study at baseline and 1-year of treatment with either losartan or atenolol, without significant valvular disease. Echo LVH was defined as LV mass >49.2 and 46.7 g/m2.7 for men and women. At year 1, the patients (58% men) had lower systolic and diastolic blood pressure (BP) and substantial reduction in LV mass, reducing LVH prevalence by 23% (from 75% at baseline to 52% at year 1); prevalence of concentric LV geometry was from 35% at baseline to 12% at year 1 (all p<0.01). Cardiac index (CI) and total peripheral resistance index (TPRI) were lower at year 1 compared to baseline (all p<0.01). (See Table) In a multiple regression model also considering baseline LV mass, systolic BP and body size, LV mass reduction was greater in women than in men (β=0.18, p<0.01), and was weakly related to reduction in systolic BP (β=0.09) and Doppler stroke volume (β=0.08, all p<0.05) (R=0.54). In conclusion, antihypertensive therapy was more effective in reducing LV mass in women, independently of BP and stroke volume changes, as well as baseline LV mass, systolic BP and body size.