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Electrocardiographic left ventricular hypertrophy regression induced by an angiotensin receptor blocker-based regimen

Vivencio Barrios1, Alberto Calderón, Carlos Escobar

  • 1Department of Cardiology, Hospital Ramón y Cajal, Madrid, Spain. vbarriosa@meditex.es

Journal of Hypertension
|September 1, 2007
PubMed

Insights

The SARA study found that candesartan-based regimens effectively reduce electrocardiographic left ventricular hypertrophy (ECG-LVH) in hypertensive patients within a clinical practice setting, demonstrating real-world efficacy.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Pharmacology

Background:

  • Angiotensin receptor blockers (ARBs) are known to be effective in reducing left ventricular hypertrophy (LVH).
  • Limited data exists on ARB efficacy for LVH regression in routine clinical practice.
  • Electrocardiographic LVH (ECG-LVH) is a significant indicator of cardiovascular risk.

Purpose of the Study:

  • To evaluate the effect of an ARB-based regimen on ECG-LVH in hypertensive outpatients.
  • To assess ARB efficacy in a real-world clinical setting.
  • To identify factors influencing ECG-LVH regression.

Main Methods:

  • The SARA study involved 264 hypertensive patients treated with candesartan-based regimens for 12 months.
  • Electrocardiographic parameters, including Cornell product (CorP), Sokolow-Lyon product (SokP), and QRS duration (QRSd), were measured.
  • Blood pressure targets were <140/90 mmHg, or <130/80 mmHg for diabetics.

Main Results:

  • A significant reduction in ECG-LVH was observed using the CorP criteria (22.9% relative risk reduction, P<0.001).
  • CorP decreased quantitatively by 84.4 mmxms (P=0.03), with greater effects in obese, diabetic, and baseline ECG-LVH patients.
  • Female gender, baseline systolic blood pressure, CorP, and QRSd were predictive factors for regression.

Conclusions:

  • A candesartan-based regimen effectively reduces ECG-LVH in hypertensive patients in daily clinical practice.
  • The findings support the use of ARBs for managing LVH in routine care.
  • Specific patient characteristics may predict a better response to treatment.
Abstract

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