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Changes in cardiovascular risk by reduction of left ventricular mass in hypertension: a meta-analysis

Paolo Verdecchia1, Fabio Angeli, Claudia Borgioni

  • 1Department of Cardiovascular Disease, Hospital R. Silvestrini, Perugia, Italy. verdec@tin.it

American Journal of Hypertension
|October 24, 2003
PubMed

Insights

Regression of left ventricular hypertrophy (LVH) during hypertension treatment significantly lowers cardiovascular disease risk. Achieving LVH regression, rather than its persistence, is key for better patient outcomes in hypertensive individuals.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • Serial changes in left ventricular (LV) mass in hypertensive patients may predict cardiovascular disease (CVD) risk.
  • Left ventricular hypertrophy (LVH) is a common adaptation to hypertension.
  • Understanding the prognostic impact of LVH regression is crucial for managing hypertensive patients.

Purpose of the Study:

  • To evaluate the prognostic significance of left ventricular hypertrophy (LVH) regression in patients with hypertension.
  • To compare cardiovascular event risk between hypertensive patients with LVH regression and those with persistent or new-onset LVH.
  • To compare cardiovascular event risk between hypertensive patients with LVH regression and those with persistently normal LV mass.

Main Methods:

  • Meta-analysis of four studies including 1064 hypertensive subjects (45-51 years old).
  • Echocardiographic LV mass assessed before and during antihypertensive therapy.
  • Cardiovascular events were tracked over 3-10 years post-initial examination.

Main Results:

  • LVH regression was associated with a significantly reduced risk of subsequent cardiovascular disease (OR 0.41, P=.007) compared to lack of regression or new LVH.
  • Subjects with LVH regression showed a similar risk of subsequent events compared to those with persistently normal LV mass (OR 0.64, P=.21).
  • Studies utilized varying definitions for LVH based on LV mass indexed to body surface area.

Conclusions:

  • Regression of left ventricular hypertrophy (LVH) during antihypertensive treatment is linked to a substantial decrease in cardiovascular disease risk.
  • Persistence or new development of LVH indicates a higher risk of cardiovascular events compared to LVH regression.
  • LVH regression represents a favorable prognostic marker in hypertensive patients undergoing treatment.
Abstract

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