title: Left Ventricular Hypertrophy Regression During Antihypertensive Treatment in an Outpatient Clinic (the Campania Salute Network).
abstract: BACKGROUND
  Regression of left ventricular (LV) hypertrophy (LVH) has been a goal in clinical trials. This study tests the external validity of results of clinical trials on LVH regression using a large registry from a tertiary care center, to identify phenotypes less likely to achieve regression of LVH.
  
  
  RESULTS
  Patients from the Campania Salute Network, free of prevalent cardiovascular disease, but with echocardiographic LVH (defined as LV mass index [LVMi] >47 g/m2.7in women and >50 g/m2.7in men) were included. During a median follow-up of 67 months, clear-cut regression of LVH was documented in 14% of patients (13±8% reduction of initial LVMi) or 23% when also considering those with a reduction of LVMi ≥5 g/m2.7. Patients with persistent LVH were older with longer duration of hypertension, suboptimal blood pressure (BP) control, larger body mass index, LV mass, and carotid intima-media thickness and included more women and subjects with diabetes mellitus, isolated systolic hypertension, and metabolic syndrome (allP<0.05). Number and class of antihypertensive drugs during follow-up did not differ between groups. In multiple logistic regression analysis, older age, female sex, obesity, higher baseline LVMi and carotid intima-media thickness, and suboptimal BP control were significant covariates of persistent LVH (allP≤0.01), independent of diabetes, duration of hypertension, isolated systolic hypertension, follow-up time and number and class of antihypertensive drugs.
  
  
  CONCLUSIONS
  Early initiation of antihypertensive treatment, aggressive BP control, and attention to metabolic aspects are critical to avoid irreversible LVH.
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.|Department of Clinical Science, University of Bergen, Norway.
authors.forename: Mai Tone
authors.initials: MT
authors.lastname: Lønnebakken
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Izzo
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: Mancusi
authors.affiliation: Department of Clinical Science, University of Bergen, Norway.
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy.|Division of Cardiology, Department of Advanced Biomedical Science, Federico II University Hospital, Naples, Italy.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Losi
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Canciello
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy.|Division of Cardiology, Department of Advanced Biomedical Science, Federico II University Hospital, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giugliano
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: De Luca
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy trimarco@unina.it.|Division of Cardiology, Department of Advanced Biomedical Science, Federico II University Hospital, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.affiliation: Hypertension Research Center, Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
mesh_terms: D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D059168:Carotid Intima-Media Thickness; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012042:Registries; D012074:Remission Induction; D012737:Sex Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: antihypertensive therapy/central agents; echocardiography; left ventricular hypertrophy; left ventricular hypertrophy regression; regression