Key result
Carvedilol improved left ventricular ejection fraction from 36% to 47% (P<0.01) in patients with hypertensive heart disease; lack of improvement predicted higher mortality (RR 5.7, 95% CI 1.3-25).
Why the study?
It was unknown whether carvedilol improved structural and functional left ventricular changes and reduced mortality in patients with hypertensive heart disease.
Does carvedilol improve left ventricular remodeling and survival in patients with hypertensive heart disease?
Observational (n=98)
Does carvedilol improve left ventricular remodeling and survival in patients with hypertensive heart disease?
Absolute Event Rate: 47% vs 36%
p-value: p=<0.01
Carvedilol therapy in hypertensive heart disease improves left ventricular ejection fraction and reverses cardiac remodeling, which is associated with a significant survival benefit.
May support carvedilol in hypertensive heart disease; hypothesis-generating and requires RCTs before practice change.
OBJECTIVES: The aim of this study was to determine if carvedilol improved structural and functional changes in the left ventricle and reduced mortality in patients with hypertensive heart disease. METHODS: Blood pressure, heart rate, echocardiographic parameters, and laboratory variables, were assessed pre and post treatment with carvedilol in 98 eligible patients. RESULTS: Carvedilol at a median dose of 50 mg/day during the treatment period in hypertensive heart disease lowered blood pressure 10/10 mmHg, heart rate 10 beats/min, improved left ventricular ejection fraction from baseline to follow-up (median: 6 years) (36%-47%)) and reduced left ventricular end-diastolic and end-systolic dimensions (62 vs 56 mm; 53 vs 42 mm, respectively, all p-values <0.01). Left ventricular ejection fraction increased in 69% of patients. Patients who did not have improved left ventricular ejection fraction had nearly six-fold higher mortality than those that improved (relative risk; 5.7, 95% confidence interval: 1.3-25, p = 0.022). CONCLUSION: Carvedilol reduced cardiac dimensions and improved left ventricular ejection fraction and cardiac remodeling in patients with hypertensive heart disease. These treatment-related changes had a favorable effect on survival.
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Dominguez et al. (2019) conducted an observational in hypertensive heart disease (n=98). Carvedilol vs. Baseline was evaluated on Left ventricular ejection fraction (p=<0.01). Carvedilol improved left ventricular ejection fraction from 36% to 47% (P<0.01) in patients with hypertensive heart disease; lack of improvement predicted higher mortality (RR 5.7, 95% CI 1.3-25).
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