Effects of clonidine and nifedipine on left ventricular hypertrophy and muscle mass in hypertensive patients.
In a parallel group randomized trial we compared the echocardiographically documented effects of clonidine (cl) versus nifedipine (nf) on left ventricular hypertrophy (LVH) and muscle mass (LVM) in hypertensive subjects. Twenty-one patients with concentric LVH (thickness of interventricular septum, IVS, and left posterior wall, LPW, above 11 mm) were given a 2D and M-mode echocardiogram before (pre) and 12 and 24 weeks, respectively, after therapy was initiated (mean oral cl dosage 150 micrograms; nf, 30 mg/day). At the end of the follow-up period in the cl group blood pressure declined by an average of 16/11 mm Hg compared with 30/20 mm Hg in the nf group (intergroup differences, NS). The thickness of the IVS decreased from a mean of 15.0 +/- 1.9 mm and 15.1 +/- 1.5 pre-therapy to 12.6 +/- 2.3 for cl (p = 0.0001) and 13.1 +/- 1.5 mm for nf (p = 0.001) after 24 weeks, respectively. This was similar to the regression of the LV posterior wall with 14.7 +/- 1.5 and 14.5 +/- 1.6 mm pre-therapy to 12.0 +/- 1.1 in the cl group (p = 0.0001) and 12.7 +/- 1.7 for nf (p = 0.006). As the internal LV-diameter were relatively constant over the treatment period, the calculated values for LVM dropped from a mean of 406.5 +/- 125.9 and 401.4 +/- 106.6 to 274.8 +/- 78.7 and 297.5 +/- 85.0 g, respectively, corresponding to -31.6 +/- 11.0% for cl (p = 0.0001) and -25.2 +/- 12.6% for nf (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Kleine
P
P
Medizinische Klinik der Medizinischen Hochschule Hannover, F.R.G.
Meissner
E
E
von Bruchhausen
V
V
Brückner
S
S
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D006332:Cardiomegaly / Q000503:physiopathology*; D003000:Clonidine / Q000494:pharmacology* / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000033:anatomy & histology; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000494:pharmacology* / Q000627:therapeutic use; D011897:Random Allocation
D009543:Nifedipine; D003000:Clonidine