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[Regression of myocardial hypertrophy in hypertensives on chronic beta-receptor block]
Insights
Metoprolol significantly reduced left-ventricular hypertrophy in patients with essential hypertension. This essential hypertension treatment lowered blood pressure and myocardial mass without affecting ventricular function.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a common condition often associated with left-ventricular hypertrophy (LVH).
- LVH is a significant risk factor for cardiovascular events.
- Effective antihypertensive therapies are crucial for managing hypertension and its complications.
Purpose of the Study:
- To evaluate the long-term effects of metoprolol on blood pressure and left-ventricular hypertrophy in patients with essential hypertension.
- To assess whether metoprolol treatment impacts ventricular function.
Main Methods:
- A study involving 25 patients with untreated essential hypertension and LVH.
- Patients received metoprolol 200 mg daily for an average of 12.7 months.
- Echocardiography was used to assess left-ventricular mass and dimensions; blood pressure was measured at rest and during exercise.
Main Results:
- Metoprolol significantly reduced resting systolic and diastolic blood pressure (P < 0.001).
- Exercise blood pressure also decreased.
- Left-ventricular mass decreased by 22.5% after 12.7 months (P < 0.001).
- Septal thickness and left-ventricular posterior wall thickness were significantly reduced.
- Left-ventricular dimensions and function remained unchanged.
Conclusions:
- Long-term metoprolol administration effectively reduces myocardial hypertrophy in patients with essential hypertension.
- Metoprolol treatment normalizes blood pressure without impairing ventricular function.
Abstract:
25 patients (24 males, 1 female; mean age 43.7 years), with previously untreated essential hypertension and echocardiographically proven left-ventricular hypertrophy, received metoprolol 200 mg daily over a period of 12.7 months, five of them additionally hydrochlorothiazide 25 mg. After four weeks, resting recumbent blood pressure had decreased from 157 +/- 18 systolic and 106 +/- 9 diastolic to 128 +/- 11 and 85 +/- 9, respectively; after 12.7 months to 123 +/- 12 and 83 +/- 8 mm Hg (P less than 0.001). On 100 W exercise the blood pressure fell from initially 206 +/- 13 and 117 +/- 9 168 +/- 12 and 97 +/- 9, after 12.7 months to 170 +/- 14 and 98 +/- 9 mm Hg. Left-ventricular mass fell from 147.0 +/- 26 g/m2 by 14% after 6.1 months, by 22.5% after 12.7 months (P less than 0.001). While the left-ventricular diameter in enddiastole and endsystole remained unchanged, septal thickness decreased from 15.5 +/- 2.1 to 14.2 +/- 2.2 mm after 6.1 months and 13.1 +/- 1.9 mm after 12.7 months (reduction of 15.5%). The corresponding values for the left-ventricular posterior wall were 11.9 +/- 1.6 before and 10.8 +/- 1.8 after 6.1 months and 10.1 +/- 1.4 mm after 12.7 months (reduction of 16%). Thus long-term administration of metoprolol resulted in a significant reduction in myocardial hypertrophy without impairment of ventricular function.