title: Electrocardiographic measures of left ventricular hypertrophy in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.
abstract: Left ventricular hypertrophy (LVH) predicts cardiovascular risk in hypertensive patients. We analyzed baseline/follow-up electrocardiographies in 26,376 Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial participants randomized to amlodipine (A), lisinopril (L), or chlorthalidone (C). Prevalent/incident LVH was examined using continuous and categorical classifications of Cornell voltage. At 2 and 4 years, prevalence of LVH in the C group (5.57%; 6.14%) was not statistically different from A group (2 years: 5.47%; P = .806, 4 years: 6.54%; P = .857) or L group (2 years: 5.64%; P = .857, 4 years: 6.50%; P = .430). Incident LVH followed similarly, with no difference at 2 years for C (2.99%) compared to A (2.57%; P = .173) or L (3.16%; P = .605) and at 4 years (C = 3.52%, A = 3.29%, L = 3.71%; P = .521 C vs. A, P = .618 C vs. L). Mean Cornell voltage decreased comparably across treatment groups (Δ baseline, 2 years = +3 to -27 μV, analysis of variance P = .8612; 4 years = +10 to -17 μV, analysis of variance P = .9692). We conclude that risk reductions associated with C treatment in secondary end points of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial cannot be attributed to differential improvements in electrocardiography LVH.
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, IA, USA; Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Ernst
authors.affiliation: Coordinating Center for Clinical Trials, Department of Biostatistics, University of Texas School of Public Health, Houston, TX, USA. Electronic address: barry.r.davis@uth.tmc.edu.
authors.forename: Barry R
authors.initials: BR
authors.lastname: Davis
authors.affiliation: Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.affiliation: Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Prineas
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Okin
authors.affiliation: Coordinating Center for Clinical Trials, Department of Biostatistics, University of Texas School of Public Health, Houston, TX, USA.
authors.forename: Alokananda
authors.initials: A
authors.lastname: Ghosh
authors.affiliation: Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Cushman
authors.affiliation: Division of Heart and Vascular Diseases, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
authors.forename: Paula T
authors.initials: PT
authors.lastname: Einhorn
authors.affiliation: Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Oparil
authors.affiliation: Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Minneapolis, MN, USA; Division of Clinical Epidemiology, Hennepin County Medical Center, Minneapolis, MN, USA; Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Grimm
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002752:Chlorthalidone / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D015994:Incidence; D008055:Lipids / Q000097:blood; D017706:Lisinopril / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D008055:Lipids; D017311:Amlodipine; D017706:Lisinopril; D002752:Chlorthalidone
keywords: Amlodipine; chlorthalidone; electrocardiography; lisinopril