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Left ventricular geometric patterns after 1 year of antihypertensive treatment

Manuel Luque1, Nieves Martell, Isabel Egocheaga

  • 1Hypertension Unit, Hospital Clinico San Carlos, Madrid, Spain. mluqueo@telefonica.net

Journal of Clinical Hypertension (Greenwich, Conn.)
|August 10, 2005
PubMed

Insights

One year of hypertension treatment lowered left ventricular mass but did not normalize geometry in many patients. Significant left ventricular hypertrophy or remodeling indicates a high-risk subgroup needing aggressive treatment.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Cardiovascular Imaging

Background:

  • Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular events like myocardial infarction and stroke.
  • Essential hypertension often leads to adaptive changes in the left ventricle.

Purpose of the Study:

  • To assess left ventricular adaptation patterns in essential hypertensives after treatment withdrawal and modification.
  • To evaluate changes in left ventricular mass and geometry following one year of antihypertensive therapy.

Main Methods:

  • Observational study of 107 essential hypertensive patients.
  • Blood pressure and left ventricular mass index (LVMI) measurements before and after 1 year of treatment.
  • Assessment of left ventricular geometry (normal, concentric remodeling, hypertrophy).

Main Results:

  • Blood pressure significantly decreased from 158/96 mm Hg to 137/83 mm Hg (p<0.001).
  • Left ventricular mass index (LVMI) decreased significantly, but only 36% of patients achieved normal left ventricular geometry.
  • Left ventricular geometry improved in 31%, remained unchanged in 51%, and worsened in 18% of patients.

Conclusions:

  • Suboptimal antihypertensive treatment can reduce LVMI but often leaves significant LVH or concentric remodeling.
  • A substantial proportion of patients remain at high cardiovascular risk despite treatment.
  • Aggressive antihypertensive strategies are recommended for patients with persistent LVH or remodeling.

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