Key result
Antihypertensive treatment with well-controlled blood pressure was associated with normal left ventricular mass, but carotid artery remodeling was independent of treatment and blood pressure control.
Why the study?
Does antihypertensive treatment and blood pressure normalization improve left ventricular mass and carotid geometry in older community-dwelling adults?
Cross-Sectional (n=614)
No
Does antihypertensive treatment and blood pressure normalization improve left ventricular mass and carotid geometry in older community-dwelling adults?
In older adults, successful blood pressure control is associated with normal left ventricular mass but does not appear to reverse carotid artery remodeling or atherosclerosis.
BP control may normalize LV mass without reversing carotid remodeling in older adults; hypothesis-generating for differential effects, needing prospective confirmation.
OBJECTIVE: While many studies have examined the relation between antihypertensive treatment and ventricular hypertrophy, relatively few data are available regarding changes in arterial structure due to blood pressure reduction. Therefore, we compared normotensive to untreated hypertensive subjects to uncontrolled (treated with elevated blood pressure values) or controlled (treated with normal blood pressure values) hypertensive older subjects. PATIENTS: Community-dwellers (age >or= 65 years) of a small town in Italy (Dicomano) underwent extensive clinical examination, echocardiography, carotid ultrasonography, and applanation tonometry. Of the 614 participants, 173 subjects were normotensive; among the hypertensive subjects, 225 were untreated (51%), 177 (40%) were uncontrolled, and only 39 (9%) were controlled. RESULTS: The majority of treated hypertensive subjects were on monotherapy (82%). Subjects with a history of coronary artery disease or stroke were more frequently treated. Controlled hypertensives had left ventricular mass index similar to normotensives but lower than uncontrolled and untreated hypertensives. There were no differences among the three hypertensive groups in carotid artery structure. Only the pressure-independent stiffness index was reduced in the treated hypertensive subjects compared to untreated hypertensives, with no difference between controlled and uncontrolled subjects. CONCLUSIONS: In our community-based, older population, antihypertensive treatment was associated with a normal left ventricular mass only when blood pressure was well controlled. In contrast, carotid artery remodeling and atherosclerosis were independent of antihypertensive treatment as well as of achievement of satisfactory blood pressure control. However, antihypertensive treatment was associated with significantly higher carotid compliance even in the absence of detectable changes in carotid structure.
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Pini et al. (2006) conducted a cross-sectional in Hypertension (n=614). Antihypertensive treatment and blood pressure control vs. Normotensive and untreated hypertensive subjects was evaluated on Left ventricular mass index and carotid artery structure. Antihypertensive treatment with well-controlled blood pressure was associated with normal left ventricular mass, but carotid artery remodeling was independent of treatment and blood pressure control.
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