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[The echocardiographic evolution of left ventricular hypertrophy in treated hypertensive patients. A long-term
1Departamento de Medicina Interna, Hospital P. Jaraquemada, Facultad de Medicina, Universidad de Chile, Santiago.
Insights
Left ventricular hypertrophy regressed in 48% of treated hypertensive patients. Propranolol and achieving normal blood pressure were linked to favorable changes, suggesting effective treatment strategies for this condition.
Area of Science:
- Cardiology
- Hypertension Management
- Echocardiography
Background:
- Left ventricular hypertrophy (LVH) is a common adaptation to hypertension.
- Regressive changes in LVH are desirable but require long-term study.
- Understanding drug effects and blood pressure reduction is crucial for LVH regression.
Purpose of the Study:
- To investigate the regression of left ventricular hypertrophy in treated hypertensive patients.
- To correlate LVH changes with specific antihypertensive drugs and achieved blood pressure reduction.
- To compare the effects of different treatment regimens on LVH over six years.
Main Methods:
- A 6-year echocardiographic follow-up study of 61 hypertensive patients.
- Measurement of interventricular septum and posterior wall thickness, and left ventricular mass index.
- Comparison of hypertrophy types (asymmetric septal vs. concentric) before and after treatment.
Main Results:
- Left ventricular hypertrophy regressed or decreased in 48% of patients.
- Favorable changes were more frequent in patients achieving normal diastolic blood pressure (<90 mmHg).
- Patients treated with propranolol showed more regression than those treated with diuretics alone.
Conclusions:
- Antihypertensive treatment can lead to regression of left ventricular hypertrophy.
- Achieving normal blood pressure levels is associated with favorable LVH changes.
- Propranolol may be more effective than diuretics in promoting LVH regression.
Abstract:
In order to study the possible regressive changes of left ventricular hypertrophy in treated hypertensive patients and to correlate them either with the drugs they received and/or the blood pressure reduction obtained, a long-term (6 years) echocardiographic follow-up study was performed in 61 patients. B and M mode echocardiographic septum and posterior wall thickness and left ventricular mass index were measured yearly and the type of ventricular hypertrophy, asymmetric septal or concentric (symmetric), were compared before and after the follow-up. Sixteen patients received only diuretics; 14, only propranolol, and associated therapy was used in the remaining 31 patients. Average blood pressure was significantly reduced in the whole group of patients, but, individually, 30 of them achieved normal levels for the diastolic (90 mmHg), remaining it over this value in the other, although all of them experienced an average reduction 10 mmHg with therapy. Those patients with concentric hypertrophy at entry showed a significant septal, posterior wall thickness and total ventricular mass reduction during the follow-up, those with initial asymmetric septal hypertrophy, a significant septal thickness and ventricular mass reduction, and those without hypertrophy on admission, showed an average paradoxical increase in septal thickness. We conclude that left ventricular hypertrophy disappeared or decreased in 48% of the patients and that treatment seems to prevent its progression or development in the 43% of all patients. The regressive or favorable changes were significantly more frequent among patients with normal blood pressure after treatment as well as among patients treated only with propranolol in comparison to those treated only with diuretics.