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Studies on left ventricular hypertrophy regression in arterial hypertension: a clear message for the clinician?

Cesare Cuspidi1, Arturo Esposito, Francesca Negri

  • 1Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy. cesare.cuspidi@unimib.it

American Journal of Hypertension
|March 29, 2008
PubMed

Insights

Clinicians need clear data on antihypertensive therapy. This study found inconsistent definitions for left ventricular hypertrophy (LVH) and poor reporting on LVH regression and blood pressure control in trials.

Area of Science:

  • Cardiology
  • Clinical Trials
  • Hypertension Research

Background:

  • Evidence-based medicine requires clear, unbiased clinical information.
  • Published randomized trials on antihypertensive therapy effects on left ventricular (LV) morphology were analyzed.
  • The analysis focused on the consistency of LV hypertrophy (LVH) definition criteria and reporting of LVH regression and blood pressure (BP) control.

Purpose of the Study:

  • To investigate the variability in defining LVH in published trials.
  • To assess the consistency in reporting LVH regression and BP control in antihypertensive therapy studies.
  • To improve the clarity and standardization of reporting in clinical trials evaluating cardiovascular outcomes.

Main Methods:

  • A PubMed search identified eligible studies published within the last 12 years.
  • Inclusion criteria included double-blind, randomized, controlled, parallel-group design with at least 50 adult hypertensive subjects and 6-month follow-up.
  • Studies compared single-drug or combination antihypertensive regimens, measuring LV mass (LVM) or wall thickness by echocardiography.

Main Results:

  • Thirty-nine trials involving 9,162 subjects were analyzed.
  • LVH was defined in 87.1% of studies, but 19 different criteria were used.
  • LVH regression was evaluated, but normalization rates were reported in only 30.7% of studies, and BP target achievement in 28.2%.

Conclusions:

  • The definition of hypertensive LVH is highly variable across studies.
  • Most published trials lack precise information on LVH regression rates, changes in LV geometry, and BP control.
  • Standardization of reporting is needed for clearer clinical guidance.
Abstract

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