Regression of left ventricular hypertrophy in patients with essential hypertension: outcome of 12 years antihypertensive treatment.
To assess the regression of cardiac hypertrophy during long-term (12 years) antihypertensive treatment, the following parameters were determined in 93 patients with essential hypertension: SV1 + RV5 by electrocardiography (ECG), and septal wall (SW) and posterior wall (PW) thickness by echocardiography (UCG). The patients were treated with a thiazide diuretic alone (group 1), thiazide + beta-blocker (group 2), thiazide + methyldopa or nifedipine (group 3) or nifedipine or methyldopa alone (group 4). The blood pressure decreased gradually within 6 months of treatment. According to ECG, regression of left ventricular hypertrophy occurred during the initial 7 years in all groups, whereas in the subsequent 5 years, statistically significant regression was found only in the patients treated with thiazide + other drugs (group 3). By UCG, which was taken only at the 7th and 12th year, regression was detectable during the last 5 years in all groups. The apparent incidence of regression of hypertrophy was lower in the thiazide-alone group (group 1) than in the thiazide + beta-blocker group (group 2), most likely due to mild hypertension in group 1. A cardiovascular accident (nonfatal myocardial infarction) occurred only in 1 patient. We conclude that during long-term antihypertensive treatment, persistent, progressive reversal of cardiac hypertrophy takes place.
Shigematsu
S
S
Department of Gerontology, Endocrinology and Metabolism, School of Medicine, Shinshu University, Matsumoto-shi, Japan.
Hiramatsu
K
K
Aizawa
T
T
Yamada
T
T
Takasu
N
N
Niwa
A
A
Miyahara
Y
Y
Tsujino
M
M
Shimizu
Z
Z
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001581:Benzothiadiazines; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D004232:Diuretics; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors