Influence of left ventricular mass regression on cardiac function in hypertensive elderly individuals

A randomized, double-blind placebo controlled trial was conducted to compare the ability of verapamil and atenolol to induce regression of left ventricular mass in elderly hypertensive patients and the effects of regression on left ventricular filling, ejection fraction, and cardiac volumes. Forty-two individuals over 60 years of age were enrolled in the protocol. Eight of 21 patients assigned to atenolol and 18 to 21 assigned to verapamil achieved blood pressure control with single-agent therapy (p less than 0.05). The addition of chlorthalidone resulted in blood pressure control in the three remaining assigned to verapamil and in ten of the remaining patients assigned to atenolol. In the verapamil group left ventricular mass index decreased from 104 +/- 5 to 85 +/- 5 g/M2, while it was unchanged in the atenolol patients (109 +/- 9 to 112 +/- 10 g/M2). In the patients in whom the left ventricular mass regressed, the peak filling rate increased from 2.42 +/- 0.2 to 3.31 +/- 0.4 EDV/s, while it did not change in the patients who did not experience regression. Furthermore, ejection fraction and cardiac output were maintained in patients who had regression, both at rest and during mild upright bicycle exercise.