Effect of hydrochlorothiazide therapy on cardiac arrhythmias in African-American men with systemic hypertension and moderate to severe left ventricular hypertrophy.
The effect of hydrochlorothiazide therapy on ventricular arrhythmias was studied in 45 hypertensive African-American men with moderate to severe left ventricular (LV) hypertrophy. After medication washout, patients were treated with placebo followed by hydrochlorothiazide. Clinical, biochemical, and 48-hour ambulatory electrocardiographic data was collected after each treatment phase. Signal-averaged electrocardiograms were recorded in a subgroup of 24 patients. Average LV posterior wall thickness was 15 +/- 1.1 mm, septum 16 +/- 2 mm, LV mass 420 +/- 90 g, and LV mass index 212 = 51 g/m2. Systolic blood pressure (BP) was 168 +/- 18 mm Hg after the placebo phase and 146 +/- 15 mm Hg after hydrochlorothiazide; diastolic BP was 103 +/- 6 mm Hg and 89 +/- 9 mm Hg, respectively. Serum potassium decreased significantly from 4.2 +/- 0.4 mmol/L to 3.7 +/- 0.6 mmol/L after hydrochlorothiazide therapy. The average hourly incidence of ventricular premature contractions was 22 with placebo and 25 with hydrochlorothiazide. There were 3 and 1 couplets and 0.2 and 0.2 runs of ventricular tachycardia per patient per hour, respectively. Variables of signal-averaged electrocardiography did not differ between the 2 treatments. Thus, in hypertensive African-American men with moderate to severe LV hypertrophy, hydrochlorothiazide does not worsen ventricular arrhythmias or signal-averaged electrocardiographic variables.
Narayan
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Hypertension Research Clinic, Department of VA Medical Center, Washington, D.C. 20422, USA.
Papademetriou
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D001741:Black or African American; D004232:Diuretics; D004452:Echocardiography; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology; D017379:Hypertrophy, Left Ventricular / Q000208:ethnology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012815:Signal Processing, Computer-Assisted; D016037:Single-Blind Method; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology*; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000209:etiology*
D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide