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Correction of hypertensive cardiac remodelling: comparison of different antihypertensive therapies

V A Almazov1, E V Shlyakhto, A O Konrady

  • 1Faculty Therapy Dept., St. Petersburg Pavlov State Medical University, 6/8 Lev Tołstoy str., St. Petersburg 197089, Russia.

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
|February 24, 2001
PubMed

Insights

Long-term use of various antihypertensive drugs effectively reduces left ventricular hypertrophy (LVH) and improves diastolic function. This cardiac remodeling benefit occurs independently of blood pressure reduction, with no single drug showing superiority.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Essential hypertension is a significant risk factor for cardiovascular complications, including left ventricular hypertrophy (LVH).
  • LVH is associated with impaired diastolic function and increased risk of heart failure.
  • Understanding the impact of different antihypertensive drug classes on cardiac structure and function is crucial for effective patient management.

Purpose of the Study:

  • To compare the effects of long-term treatment with nifedipine, atenolol, losartan, and perindopril on LVH and diastolic function in hypertensive patients.
  • To investigate whether the observed changes in cardiac remodeling are related to blood pressure reduction.

Main Methods:

  • A six-month prospective study involving 60 middle-aged patients with mild to moderate essential hypertension.
  • Patients received one of four antihypertensive drugs: nifedipine-retard, atenolol, losartan potassium, or perindopril.
  • Echocardiography was used to assess left ventricular mass index (LVMI), relative wall thickness (RWT), and diastolic function parameters (E/A ratio, IVRT).

Main Results:

  • All drug treatments led to a significant decrease in LVMI and RWT, indicating reversal of LVH.
  • The reduction in LVH was more pronounced in patients with higher baseline LVMI and was independent of blood pressure reduction.
  • Diastolic function parameters improved, suggesting enhanced cardiac relaxation and filling.

Conclusions:

  • Long-term treatment with nifedipine, atenolol, losartan, and perindopril improves cardiac structure and diastolic function in hypertensive patients.
  • The beneficial effects on cardiac remodeling are independent of the drugs' blood pressure-lowering effects.
  • No specific drug demonstrated superiority in improving cardiac remodeling, suggesting a class effect for these antihypertensives.

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