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Cardiovascular and renal effects of long-term antihypertensive treatment
M Hartford1, I Wendelhag, G Berglund
1Department of Medicine, Sahlgrenska Hospital, University of Gothenburg, Sweden.
Insights
Antihypertensive treatment with metoprolol tartrate normalized circulatory system function in hypertensive men. Long-term therapy reversed cardiovascular structural changes, including left ventricular hypertrophy and microalbuminuria.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Hypertension is associated with structural cardiovascular changes.
- Restoration of normal circulatory function is a key treatment goal.
Purpose of the Study:
- To investigate if antihypertensive treatment can restore normal circulatory system function.
- To assess the impact of long-term metoprolol tartrate therapy on cardiovascular structure and function.
Main Methods:
- Longitudinal study of 13 hypertensive men and 37 normotensive controls.
- Investigated hemodynamic variables, cardiac structure/function (echocardiography, apexcardiography, plethysmography), and renal function (clearance tests, albuminuria) over seven years.
- Hypertensive men received metoprolol tartrate therapy after initial assessment.
Main Results:
- Seven years of treatment normalized central and peripheral hemodynamic variables.
- Reversed left ventricular hypertrophy, normalized systolic and diastolic left ventricular function, and normalized systolic wall stress.
- Reduced microalbuminuria and renal vascular resistance without affecting glomerular filtration rate.
Conclusions:
- Long-term antihypertensive treatment can lead to regression of cardiovascular structural changes.
- Metoprolol tartrate therapy effectively restored circulatory system function in hypertensive individuals.
Abstract:
To study whether restoration of a normal circulatory system could be achieved with antihypertensive treatment, 13 hypertensive men with structural cardiovascular changes and 37 normotensive control subjects were investigated by echocardiography, apexcardiography, plethysmography, inulin and p-amino-hippurate clearance, and determination of 24-hour urinary excretion of albumin, first at age 49 years and again seven years later. All men were untreated at the first investigation. Immediately thereafter, therapy with the cardioselective beta-adrenoceptor blocker metoprolol tartrate was initiated in the hypertensive men. Seven years of antihypertensive treatment resulted in (1) normalization of central and peripheral hemodynamic variables, (2) reversal of left ventricular hypertrophy in proportion to achieved blood pressure control, (3) normalization of systolic wall stress and a well-preserved systolic left ventricular function, (4) normalization of diastolic left ventricular function, and (5) normalization of increased microalbuminuria and a decrease in renal vascular resistance, with no change in glomerular filtration rate compared with control subjects. In conclusion, the findings strongly indicate that regression of cardiovascular structural changes can be achieved with long-term antihypertensive treatment.