Blood pressure normalization is associated with normal left ventricular mass but not carotid geometry: the ICARe Dicomano Study.
OBJECTIVE
While many studies have examined the relation between antihypertensive treatment and ventricular hypertrophy, relatively few data are available regarding changes in arterial structure due to blood pressure reduction. Therefore, we compared normotensive to untreated hypertensive subjects to uncontrolled (treated with elevated blood pressure values) or controlled (treated with normal blood pressure values) hypertensive older subjects.


METHODS
Community-dwellers (age >or= 65 years) of a small town in Italy (Dicomano) underwent extensive clinical examination, echocardiography, carotid ultrasonography, and applanation tonometry. Of the 614 participants, 173 subjects were normotensive; among the hypertensive subjects, 225 were untreated (51%), 177 (40%) were uncontrolled, and only 39 (9%) were controlled.


RESULTS
The majority of treated hypertensive subjects were on monotherapy (82%). Subjects with a history of coronary artery disease or stroke were more frequently treated. Controlled hypertensives had left ventricular mass index similar to normotensives but lower than uncontrolled and untreated hypertensives. There were no differences among the three hypertensive groups in carotid artery structure. Only the pressure-independent stiffness index was reduced in the treated hypertensive subjects compared to untreated hypertensives, with no difference between controlled and uncontrolled subjects.


CONCLUSIONS
In our community-based, older population, antihypertensive treatment was associated with a normal left ventricular mass only when blood pressure was well controlled. In contrast, carotid artery remodeling and atherosclerosis were independent of antihypertensive treatment as well as of achievement of satisfactory blood pressure control. However, antihypertensive treatment was associated with significantly higher carotid compliance even in the absence of detectable changes in carotid structure.
Pini
Riccardo
R
Department of Critical Care Medicine and Surgery - Unit of Gerontology and Geriatrics, University of Firenze and the Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy. rpini@unifi.it
Cavallini
M Chiara
MC
Staglianò
Loredana
L
Tarantini
Francesca
F
Marchionni
Niccolò
N
Di Bari
Mauro
M
Devereux
Richard B
RB
Masotti
Giulio
G
Roman
Mary J
MJ
D000368:Aged; D000886:Anthropometry; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003187:Compliance / Q000187:drug effects; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008365:Manometry; D013599:Systole
D000959:Antihypertensive Agents