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Reverse remodeling and improved function by antihypertensive treatment in hypertensive patients with coronary artery

Yoshiki Yui1, Kazuhisa Kodama, Atsushi Hirayama

  • 1Department of Cardiovascular Medicine, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan. yoshiki@kuhp.kyoto-u.ac.jp

Journal of Hypertension
|November 21, 2009
PubMed

Insights

Nifedipine retard and angiotensin-converting enzyme inhibitors (ACE-Is) similarly improve cardiac remodeling and function in hypertensive patients with coronary artery disease. Lowering blood pressure with either treatment offers significant benefits for left ventricular structure and function.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Antihypertensive therapy is known to reduce cardiovascular events.
  • The comparative effects of nifedipine retard and ACE inhibitors on cardiac remodeling and function remain unclear.
  • Understanding how antihypertensive treatments influence cardiac structure and function is crucial.

Purpose of the Study:

  • To compare cardiac remodeling and function changes between nifedipine retard and ACE inhibitors in hypertensive patients with coronary artery disease.
  • To investigate the influence of antihypertensive therapy on cardiac structure and function.

Main Methods:

  • Randomized trial involving 210 hypertensive patients with coronary artery disease, treated for 3 years.
  • Patients were assigned to either nifedipine retard (n=108) or ACE inhibitors (n=102).
  • Primary endpoints: changes in end-diastolic volume index (EDVI) and end-systolic volume index (ESVI). Secondary endpoints: ejection fraction (EF), stroke volume index (SVI), cardiac index (CI), and regional wall motion assessed by left ventriculography.

Main Results:

  • Both nifedipine retard and ACE inhibitors demonstrated comparable improvements in cardiac remodeling and function.
  • Significant reductions in EDVI and ESVI, alongside significant increases in EF, SVI, and CI, were observed in both groups.
  • Regional wall motion significantly improved, with weak correlations noted between blood pressure reduction and changes in cardiac parameters.

Conclusions:

  • Nifedipine retard and ACE inhibitors yield similar beneficial effects on cardiac remodeling and function.
  • Blood pressure reduction through either therapy promotes reverse remodeling and enhances cardiac function in this patient population.
  • Lowering blood pressure is critical for hypertensive patients with coronary artery disease, offering favorable effects on left ventricular structure and function.
Abstract

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