title: Impact of age on left ventricular hypertrophy regression during antihypertensive treatment with losartan or atenolol (the LIFE study).
abstract: To assess the influence of age on changes in left ventricular (LV) mass and geometry during antihypertensive treatment, we related age to clinical and echocardiographic findings before and after 4 years of antihypertensive treatment in a subset of 560 hypertensive patients without known concurrent disease in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, which randomized patients to blinded losartan- or atenolol-based treatment. Patients >/=65 years (older group) included more women and patients with isolated systolic hypertension or albuminuria (all P<0.05). Compared to patients <65 years, older patients had higher pulse pressure, LV mass, and prevalence of concentric hypertrophy at baseline (78 vs 69 mmHg, 234 vs 224 g, and 28 vs 16%, respectively, all P<0.01), while the mean blood pressure did not differ. Over 4 years, reductions in LV mass and the mean blood pressure were similar in both groups, but older patients more often had residual hypertrophy (31 vs 15%, P<0.001) with a preponderance of eccentric geometry. In multivariate analysis of 4-year change in LV mass controlling for baseline mass, larger hypertrophy reduction was associated with losartan treatment, while age, gender, body mass index, and 4-year change in pulse pressure and albuminuria did not enter (Multiple R (2)=0.40, P<0.001). Thus, in up-to-80-year-old hypertensive patients with left ventricular hypertrophy, age did not significantly attenuate hypertrophy reduction during antihypertensive treatment, although residual hypertrophy was more prevalent in older patients as a consequence of higher initial LV mass.
authors.affiliation: Institute of Medicine, University of Bergen, Norway. evgerdts@online.no
authors.forename: E
authors.initials: E
authors.lastname: Gerdts
authors.forename: M J
authors.initials: MJ
authors.lastname: Roman
authors.forename: V
authors.initials: V
authors.lastname: Palmieri
authors.forename: K
authors.initials: K
authors.lastname: Wachtell
authors.forename: G
authors.initials: G
authors.lastname: Smith
authors.forename: M S
authors.initials: MS
authors.lastname: Nieminen
authors.forename: B
authors.initials: B
authors.lastname: Dahlöf
authors.forename: R B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000188:drug therapy; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D000959:Antihypertensive Agents; D001262:Atenolol; D019808:Losartan