Changes in left ventricular anatomy and systemic hemodynamics induced by antihypertensive therapy with indenolol

In 20 patients with mild or moderate essential hypertension who responded favorably to indenolol antihypertensive therapy, echocardiography was performed in the basal condition and 6 and 12 months after the beginning of permanent antihypertensive treatment. Indenolol induced a significant decrease in blood pressure, from a basal value of 170 +/- 3/100 +/- 8 mmHg to 142 +/- 4/87 +/- 2 mmHg after 6 months (p less than 0.01) and to 133 +/- 4/84 +/- 2 mmHg after 1 year (p less than 0.01), and in heart rate, from 72 +/- 5 to 61 +/- 3 bpm after 6 months (p less than 0.01) and to 60 +/- 2 bpm after 1 year (p less than 0.01). Simultaneously, there was a significant reduction in cardiac output (from 6.3 +/- .4 to 5.7 +/- .2 liters/min after 6 months, p less than 0.05, and to 5.6 +/- .2 liters/min after 1 year, p less than 0.01), due to a reduction in heart rate, increased stroke volume, and improved left ventricular performance after indenolol. Total peripheral resistance was also reduced, although statistical significance was not attained. However, a significant inverse correlation was found between the initial value of cardiac output and total peripheral resistance and the changes in these parameters induced by indenolol treatment (cardiac output: r = -0.824 and -0.855, total peripheral resistance: r = -0.876 and -0.899 at 6- and 12-month controls, respectively, all p less than 0.001). Finally, there was a parallel decrease in left ventricular wall and septal thickness and estimated left ventricular mass in patients with left ventricular hypertrophy, whereas no change in left ventricular anatomy could be detected in patients with normal left ventricular mass.