title: Trends in hypertension control and left ventricular hypertrophy over three years.
abstract: BACKGROUND
  The aim of this study was to describe trends in blood pressure (BP) control and in the prevalence of left ventricular hypertrophy (LVH) during 3 years of follow-up in a representative sample of treated hypertensive patients seen in our out-patient hypertension hospital clinic.
  
  
  METHODS
  Four hundred and sixty-four hypertensive treated patients who took part in a clinical survey at our out-patient clinic during the year 1997 and who had been submitted to a routine follow-up visit 3 years later were included in the study. All patients were subjected to the following procedures: an accurate medical history, physical examination, electrocardiogram, clinical BP measurement. For the diagnosis of LVH we used two different ECG criteria: the Solokow-Lyon voltage and the gender-specific Cornell voltage.
  
  
  RESULTS
  During the first survey, 15% of treated patients had a clinical BP < 130/85 mmHg, 25.1% > or = 130/85 mmHg and < 140/90 mmHg, 33.6% > or = 140/90 and < 150/95 mmHg, 26.3% > or = 150/95 mmHg. The corresponding figures in the second survey were 19, 26.7, 33.2 and 21.1%, respectively. Overall, from the first to the second survey the prevalence of an effective BP control (< 140/90 mmHg) rose from 40.1 to 46.7% (p < 0.01). At baseline, 40 patients had ECG LVH (8.6%); at the second visit, LVH was found to have regressed in 19 of these patients. Among the 424 patients with a normal baseline electrocardiogram, 3 developed LVH during follow-up. Hence, the prevalence of LVH decreased from 8.6 to 5.1% (p < 0.01). In terms of treatment, the prevalence of combination therapy regimens increased from 68.6 to 79.7% (p < 0.05).
  
  
  CONCLUSIONS
  This study demonstrates that in hypertensive patients managed in a hypertension hospital clinic, BP control improved during the long-term follow-up and that this trend was associated with a significant regression in ECG LVH.
authors.affiliation: Institute of Internal Medicine, Centro di Fisiologia Clinica e Ipertensione, University of Milan, Ospedale Maggiore IRCCS, Milan, Italy. dhipertensione@libero.it
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Iassen
authors.initials: I
authors.lastname: Michey
authors.forename: Stefano
authors.initials: S
authors.lastname: Meani
authors.forename: Barbara
authors.initials: B
authors.lastname: Severgnini
authors.forename: Veronica
authors.initials: V
authors.lastname: Fusi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Salerno
authors.forename: Cristiana
authors.initials: C
authors.lastname: Valerio
authors.forename: Fabio
authors.initials: F
authors.lastname: Magrini
authors.forename: Alberto
authors.initials: A
authors.lastname: Zanchetti
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D015995:Prevalence
chemical_list: D000959:Antihypertensive Agents