title: Diastolic blood pressure reduction contributes more to the regression of left ventricular hypertrophy: a meta-analysis of randomized controlled trials.
abstract: Left ventricular hypertrophy (LVH) is an independent cardiovascular risk factor; however, the key strategy necessary for LVH regression in hypertensive patients is not clear. A meta-analysis was conducted to study the effect of blood pressure reduction on LVH regression. We explored the relationship between different degrees of systolic blood pressure (SBP)/diastolic blood pressure (DBP) reduction and LVH regression. A total of 17 randomized controlled trials comprising 2196 hypertensive patients (mean age, 56.3 years; 64.1% were men) were identified. Different degrees of SBP and DBP reductions were significantly associated with LVH regression: SBP reduction ≥20  mm  Hg (SBPM20) (weighted mean difference (WMD): 14.35  g  m(-2); 95% confidence interval (CI): 10.44, 18.26; P<0.0001); SBP reduction <20  mm  Hg (SBPL20 group) (WMD: 14.82  g  m(-2); 95% CI: 9.83, 19.8(2); P<0.0001); DBP reduction ≥10  mm  Hg (DBPM10 group) (WMD: 15.17 g m(-2); 95% CI: 11.86, 18.48; P<0.0001); and DBP reduction <10  mm  Hg (DBPL10 group) (WMD: 11.76  g  m(-2); 95% CI: 3.75, 19.76; P=0.004). Significant regression of LVH was found in the DBPM10 group compared with the SBPM20, SBPL20 and DBPL10 groups (P<0.0001). The most significant decrease in LVH was seen in patients with a mean age over 60 years in the DBPM10 group. Moreover, the renin-angiotensin system inhibitor was found to be the most effective antihypertensive drug for LVH regression. This meta-analysis result indicates that proper DBP reduction plays an important role in the regression of echocardiographic LVH in hypertensive patients.
authors.affiliation: 1] Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China [2] Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China.
authors.forename: K
authors.initials: K
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.forename: T
authors.initials: T
authors.lastname: Wang
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.forename: H
authors.initials: H
authors.lastname: Huang
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D003971:Diastole; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013599:Systole; D016896:Treatment Outcome; D014463:Ultrasonography; D020257:Ventricular Remodeling
chemical_list: D000959:Antihypertensive Agents