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Prognostic significance of left ventricular mass change during treatment of hypertension

Richard B Devereux1, Kristian Wachtell, Eva Gerdts

  • 1Department of Medicine, New York Presbyterian Hospital, Cornell Medical Center, New York, NY 10021, USA. rbdevere@med.cornell.edu

JAMA
|November 18, 2004
PubMed

Insights

Lowering left ventricular (LV) mass during hypertension treatment significantly reduces cardiovascular events, independent of blood pressure changes. This finding highlights LV mass as a crucial therapeutic target for better hypertension outcomes.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Trials

Background:

  • Elevated baseline left ventricular (LV) mass is a known predictor of cardiovascular (CV) complications in hypertension.
  • The impact of LV mass reduction on CV outcomes during antihypertensive therapy remains unclear.

Purpose of the Study:

  • To investigate if reducing LV mass during antihypertensive treatment independently modifies the risk of major CV events.
  • To assess the relationship between LV mass reduction and CV event rates beyond blood pressure changes.

Main Methods:

  • Prospective cohort substudy of the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) trial.
  • 941 hypertensive patients with LV hypertrophy underwent echocardiography for LV mass measurement.
  • Patients were followed for a mean of 4.8 years for major CV events.

Main Results:

  • Lower in-treatment LV mass index was strongly associated with a reduced rate of composite CV end points (CV death, myocardial infarction, stroke).
  • This association persisted independently of blood pressure reduction and assigned treatment.
  • Significant reductions were observed for CV mortality, stroke, and all-cause mortality with lower LV mass.

Conclusions:

  • In hypertensive patients with LV hypertrophy, reduced LV mass during treatment is linked to lower clinical event rates.
  • LV mass reduction offers prognostic benefits beyond blood pressure lowering and treatment type.
  • Targeting LV mass may be a valuable strategy in managing hypertension and its CV complications.
Abstract

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