title: Left ventricular mass regression in the LIFE study: effect of previous antihypertensive treatment.
abstract: BACKGROUND
  Whether to include only those patients who have not had prior hypertension treatment in clinical trials of left ventricular (LV) mass reduction is controversial. Accordingly, our aim was to study the relationship between prior treatment and both baseline and 1-year echocardiographic LV mass in subjects enrolled in the Losartan Intervention For Endpoint reduction (LIFE) study.
  
  
  METHODS
  We studied clinical and baseline echocardiographic data on 960 patients with electrocardiographically confirmed left ventricular hypertrophy enrolled in the electrocardiographic substudy of the LIFE study, 847 of whom had LV mass remeasured after 1 year of blinded treatment. The majority (75%) of these patients had prior medical treatment for hypertension.
  
  
  RESULTS
  In multivariable regression analysis, controlling for age, sex, blood pressure (BP), body mass index, and indices of pump and myocardial function, prior antihypertensive treatment was not associated with either greater LV mass or relative wall thickness on the baseline study. Moreover, there was no significant difference between the 637 subjects who were previously treated and the 210 who were not treated with regard to the mean reduction in systolic or diastolic pressures (-25 +/- 17 v -24 +/- -16 and -13 +/- 9 mm Hg v -12 +/- 9 mm Hg), LV mass (-27 +/- 38 v -29 +/- 34 g), or LV mass/body surface area (-14 +/- 20 v -15 +/- 18 g/m(2)), all P >.05.
  
  
  CONCLUSIONS
  Prior treatment is not associated with either greater LV mass or greater relative wall thickness when age, body mass index, sex, systolic BP, heart rate, or indices of LV volume load and systolic function are taken into account. In addition, prior treatment is not associated with lesser degrees of LV mass reduction. For design of future clinical trials, restriction of inclusion criteria to only previously untreated patients does not appear to be necessary when the selection criterion is electrocardiographically determined left ventricular hypertrophy.
authors.affiliation: Department of Medicine, Division of Cardiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA. aurigemg@ummhc.org
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Aurigemma
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
authors.forename: Kristian
authors.initials: K
authors.lastname: Wachtell
authors.forename: Vittorio
authors.initials: V
authors.lastname: Palmieri
authors.forename: Kurt
authors.initials: K
authors.lastname: Boman
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
authors.forename: Markku S
authors.initials: MS
authors.lastname: Nieminen
authors.forename: Vasilios
authors.initials: V
authors.lastname: Papademetriou
authors.forename: Bjorn
authors.initials: B
authors.lastname: Dahlöf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D019808:Losartan