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Regression of left ventricular hypertrophy during combined atenolol and nifedipine treatment
I W Franz1, U Tönnesmann, U Behr
1Department of Cardiology, Klinikum Charlottenburg, Free University, West Berlin.
Insights
This study shows that combining atenolol and nifedipine effectively lowers blood pressure and reduces left ventricular hypertrophy in hypertensive patients. The treatment demonstrated significant improvements in cardiac structure without negatively impacting heart function.
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 preventing cardiac remodeling.
Purpose of the Study:
- To evaluate the efficacy of a fixed-dose combination of atenolol and sustained-release nifedipine in treating essential hypertension with LVH.
- To assess the impact of this combination therapy on left ventricular structure and function.
- To determine the effects on both resting and exercise blood pressure.
Main Methods:
- A study involving 36 patients with untreated essential hypertension and LVH.
- Patients received a fixed-dose combination of atenolol (50 mg) and sustained-release nifedipine (20 mg) once daily.
- Echocardiography was used to measure left ventricular parameters, and blood pressure was monitored at rest and during exercise.
Main Results:
- Significant reductions in interventricular septal thickness, posterior wall thickness, and left ventricular mass index were observed.
- Blood pressure was significantly reduced from 153/105 mm Hg to 122/79 mm Hg at rest and from 189/109 to 157/93 mm Hg during exercise.
- Left ventricular dimensions and fractional shortening remained unchanged, indicating preserved cardiac function.
Conclusions:
- The combination of atenolol and nifedipine effectively reduces blood pressure in patients with essential hypertension and LVH.
- This therapy leads to significant regression of left ventricular hypertrophy.
- The treatment combination achieves these benefits without compromising left ventricular function.
Abstract:
36 patients with previously untreated essential hypertension and left ventricular hypertrophy were treated with a fixed dose combination of atenolol 50 mg and sustained release nifedipine 20 mg once daily for a mean period of 12.1 months. Echocardiography showed a significant decrease after a mean period of 7.9 months in interventricular septal thickness (13.6%, p less than 0.01), posterior wall thickness (12.6%, p less than 0.001) and left ventricular mass index (18.3%). After 12.1 months the reductions were 20.7% (p less than 0.001), 22.5% (p less than 0.001) and 30.8% (p less than 0.001), respectively. Posterior wall thickness was significantly reduced, but left ventricular end-systolic and end-diastolic dimensions and fractional shortening remained unchanged. Treatment significantly reduced resting blood pressure from 153/105 mm Hg to 122/79 mm Hg (p less than 0.001), and exercise blood pressure at 100W from 189/109 to 157/93 mm Hg (p less than 0.001). Thus, nifedipine in combination with atenolol produces significant blood pressure reduction accompanied by regression of left ventricular hypertrophy without noticeable changes in left ventricular function.