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Regression of left ventricular hypertrophy by acebutolol and nifedipine
I W Franz1, U Tönnesmann, U Behr
1Klinik Wehrawald der BfA, Todtmoos, Federal Republic of Germany.
Insights
Fixed-dose acebutolol and nifedipine significantly reduced blood pressure and reversed left ventricular hypertrophy in hypertensive patients. This combination therapy improved cardiac structure without impairing left ventricular function over 25 months.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is often associated with left ventricular hypertrophy (LVH).
- LVH is a significant risk factor for cardiovascular events.
- Effective blood pressure control is crucial for managing hypertension and LVH.
Purpose of the Study:
- To evaluate the efficacy of a fixed-dose combination of acebutolol and nifedipine in treating essential hypertension with LVH.
- To assess the impact of this combination therapy on left ventricular structure and function.
Main Methods:
- Fourteen patients with untreated essential hypertension and LVH received acebutolol 200 mg and nifedipine 20 mg daily.
- Echocardiography was used to measure interventricular septal thickness, posterior wall thickness, left ventricular mass index, and dimensions.
- Blood pressure was monitored at rest and during exercise.
Main Results:
- Significant reductions in interventricular septal thickness (29%), posterior wall thickness (28.1%), and left ventricular mass index (38.7%) were observed after 25.6 months.
- Resting blood pressure decreased from 161/102 mmHg to 132/87 mmHg.
- Exercise blood pressure also showed significant reductions.
- Left ventricular dimensions and fractional shortening remained unchanged.
Conclusions:
- The combination of nifedipine and acebutolol effectively reduces blood pressure in patients with essential hypertension and LVH.
- This treatment leads to significant regression of left ventricular hypertrophy.
- The therapy does not adversely affect left ventricular function.
Abstract:
Fourteen patients with previously untreated essential hypertension and left ventricular hypertrophy were treated with a fixed-dose combination of acebutolol 200 mg and nifedipine 20 mg once daily for a followup of 25.6 +/- 1.8 months. Echocardiography showed a significant decrease after a mean period of 6.6 months in interventricular septal thickness (14.8%, p less than 0.001), posterior wall thickness (14.8%, p less than 0.001), and left ventricular mass index (21.3%). After 25.6 months, the reductions were 29% (p less than 0.001), 28.1% (p less than 0.001), and 38.7% (p less than 0.001), respectively. Left wall thickness was significantly reduced, but left ventricular end-systolic and end-diastolic dimensions and fractional shortening remained unchanged. Treatment reduced resting blood pressure from 161/102 mmHg to 132/87 mmHg (p less than 0.001) and reduced exercise blood pressure at 100 W from 208/113 mmHg to 170/94 mmHg (p less than 0.001). Thus, nifedipine in combination with acebutolol produces significant blood-pressure reduction accompanied by regression of left ventricular hypertrophy without noticeable changes in left ventricular function.