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Management of essential hypertension in patients with different degrees of left ventricular hypertrophy. Multicenter

A P Yurenev1, H G Dyakonova, I D Novikov

  • 1USSR Cardiology Research Center, Academy of Sciences of the USSR, Moscow.

American Journal of Hypertension
|June 1, 1992
PubMed

Insights

Beta-blockers significantly reduce mortality in hypertensive patients with left ventricular hypertrophy (LVH). Regression of LVH improves prognosis, highlighting its prognostic value for cardiovascular complications.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Pharmacology

Background:

  • Hypertension frequently leads to left ventricular hypertrophy (LVH).
  • LVH is associated with increased risk of cardiovascular complications.
  • Optimal management strategies for hypertensive patients with LVH require investigation.

Purpose of the Study:

  • To evaluate the impact of beta-blockers versus diuretics on mortality and nonfatal endpoints in hypertensive patients with LVH.
  • To assess the prognostic value of left ventricular myocardial mass (LVMM) for cardiovascular complications.

Main Methods:

  • A 4-year randomized controlled trial involving 304 hypertensive patients with varying degrees of LVH.
  • Group I received hypotensive drugs including beta-blockers; Group II received hypotensive drugs including diuretics.
  • Endpoints included stroke, myocardial infarction, chronic coronary insufficiency, and mortality.

Main Results:

  • Mortality was significantly higher in the diuretic group (5%) compared to the beta-blocker group (1%) (P < .035).
  • No significant difference in nonfatal endpoints between the two groups.
  • Increased LVMM (>200 g) was a strong predictor of fatal and nonfatal cardiovascular complications (P < .0003 for all complications).

Conclusions:

  • Beta-blockers are effective in reducing mortality in hypertensive patients with LVH.
  • Regression of LVH to below 200 g significantly improves prognosis.
  • LVMM is a critical prognostic marker for cardiovascular events in hypertensive individuals.

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