Why the study?
Does long-term antihypertensive therapy reduce left ventricular mass index in previously untreated hypertensive patients with LVH?
Does long-term antihypertensive therapy reduce left ventricular mass index in previously untreated hypertensive patients with LVH?
Long-term antihypertensive therapy significantly reduces left ventricular mass index and improves fractional fiber shortening in patients with left ventricular hypertrophy, with almost complete regression achieved in 82% of patients.
Supports LVH regression via prolonged antihypertensives in observational data; leaves open randomized confirmation of outcome benefits.
The long-term effects of antihypertensive therapy on echocardiographically proven left ventricular hypertrophy (LVH) were investigated in 117 previously untreated hypertensive patients (mean age of 46 +/- 9 years; 15 women, 102 men). Twenty-two patients (group 1) received daily 100 mg of gallopamil, 25 (group 2) received 200 mg of metoprolol, 35 (group 3) received both 50 mg of atenolol and 20 mg of nifedipine (follow-up of 5 years), 14 (group 4) received 200 mg of acebutolol and 20 mg of nifedipine, and 21 (group 5) daily received 50 mg of atenolol and 10 mg of enalapril (follow-up of 4 years). For the entire population, there was a significant (p less than 0.001) decrease in left ventricular mass index (LVMI) of 24.5% after 1 year, which increased further to 44.1% after 5 years of treatment. In addition, fractional fiber shortening increased by 16% (p less than 0.001). In 82% of the patients, almost complete regression of LVH was achieved. However, the time course of regression of LVMI differed significantly between the five treatment groups, despite similar blood pressure reduction under resting conditions.
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Franz et al. (1991) studied this question.
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