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Special considerations in the elderly patient.

G Gerstenblith1

  • 1Johns Hopkins Hospital, Baltimore, Maryland 21205.

Journal of Human Hypertension
|December 1, 1990
PubMed
Summary
This summary is machine-generated.

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Verapamil, a calcium blocker, more effectively reduces left ventricular (LV) mass in elderly hypertensive patients than atenolol, a beta-blocker. This reduction improves diastolic filling without impairing cardiac function.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Elderly hypertensive patients present unique treatment challenges, including altered physiology and comorbidities.
  • The role of reducing left ventricular (LV) mass as a therapeutic target in this population is debated.

Purpose of the Study:

  • To compare the efficacy of verapamil (calcium blocker) versus atenolol (beta-blocker) in reducing LV mass in elderly hypertensive patients.
  • To assess the impact of LV mass reduction on LV filling and contractile performance.

Main Methods:

  • A six-month, double-blind, randomized study involving 42 hypertensive patients over 60 years old.
  • Patients received escalating doses of long-acting verapamil or atenolol.
  • LV mass was measured using two-dimensional echocardiography; diastolic filling and contractile performance were assessed via gated blood pool scans.

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Main Results:

  • Both verapamil and atenolol lowered blood pressure, but atenolol required more frequent addition of chlorthalidone.
  • Verapamil significantly reduced LV mass index, while atenolol did not.
  • LV mass reduction with verapamil was associated with improved peak filling rate and peak filling to peak ejection ratio, without compromising cardiac output or ejection fraction.

Conclusions:

  • Verapamil is more effective than atenolol in reducing LV mass in elderly hypertensive patients.
  • Reduction of LV mass by verapamil therapy improves diastolic filling and maintains contractile performance.