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Cardiac hypertrophy in hypertension
R Cífková1, P Frídl, J Skibová
1Postgraduate Medical and Pharmaceutical Institute, Czechoslovak Academy of Sciences, Prague.
Insights
Antihypertensive treatment effectively reduces left ventricular hypertrophy (LVH) in middle-aged patients. Regression of LVH occurred rapidly, particularly within the first three months, without negatively impacting left ventricular function.
Area of Science:
- Cardiology
- Hypertension Research
- Medical Imaging
Background:
- Left ventricular hypertrophy (LVH) is a common complication of hypertension.
- Understanding the time course and factors influencing LVH regression is crucial for patient management.
- Echocardiography plays a key role in assessing cardiac structure and function in hypertensive individuals.
Purpose of the Study:
- To investigate the regression of left ventricular hypertrophy (LVH) in hypertensive patients.
- To analyze changes in left ventricular function during antihypertensive therapy.
- To compare the effects of beta-blockers and methyldopa on LVH regression.
Main Methods:
- A three-year follow-up study involving 52 middle-aged hypertensive patients.
- Patients were treated with either beta-blockers or methyldopa, with additions of diuretics/vasodilators as needed.
- Echocardiography was used to measure left ventricular mass, posterior wall thickness, and interventricular septum thickness.
Main Results:
- Significant blood pressure reduction was observed, most pronounced in the first three months.
- The greatest decrease in posterior wall and interventricular septum thickness occurred within the first three months.
- Complete regression of posterior wall hypertrophy was seen within six months; septum regression continued for two years. Overall, 57.7% showed complete regression, with incomplete regression in 38.4% of obese patients.
Conclusions:
- Antihypertensive therapy leads to significant regression of left ventricular hypertrophy (LVH) in hypertensive patients.
- LVH regression is a relatively rapid process, particularly in the initial months of treatment.
- Regression of LVH was not associated with deterioration of left ventricular function and occurred irrespective of specific drug classes used.
Abstract:
The time course of regression of left ventricular hypertrophy and changes in left ventricular function were followed in 52 middle-aged hypertensive patients divided into two groups: 30 treated with betablockers and 22 with methyldopa. In case of inadequate blood pressure control, diuretics and/or vasodilators were added in both groups. Blood pressure decreased significantly over a three-year follow-up period. The decrease was most pronounced during the first three months. The biggest decrease in posterior wall and interventricular septum thickness was detected by echocardiography also within the first three months. While complete regression of posterior wall hypertrophy was noted within the next three months, interventricular septum thickness decreased steadily over a period of two years. No significant change was seen in the septum in the third year of follow-up. Complete regression of hypertrophy was found in 30 (57.7%) of probands, with no change altogether observed in as few as two patients. Regression was incomplete in 20 (38.4%) obese patients with manifest hypertrophy at the start of the study. Regression of hypertrophy was not associated with left ventricular function deterioration and was observed even after vasodilator administration. There were no differences between the two groups of patients.