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[Left axis deviation and left anterior hemiblock in patients with essential hypertension during antihypertensive
Insights
Antihypertensive treatment did not alter ECG findings like left axis deviation (LAD) or left anterior hemiblock (LAH) in essential hypertension patients over four years. Some patients showed new LAD, but existing LAH remained unchanged.
Area of Science:
- Cardiology
- Hypertension Research
Context:
- Essential hypertension is a common cardiovascular condition.
- Electrocardiogram (ECG) is a key diagnostic tool for cardiac abnormalities.
- Longitudinal studies are crucial for understanding treatment effects on hypertensive heart disease.
Purpose:
- To evaluate the impact of antihypertensive treatment on ECG abnormalities in patients with essential hypertension.
- To assess changes in left axis deviation (LAD) and left anterior hemiblock (LAH) over a 4-year period.
- To investigate the relationship between LAD, LAH, and left ventricular hypertrophy (LVH).
Summary:
- This study analyzed ECGs of 127 patients with essential hypertension undergoing antihypertensive treatment.
- Initial ECGs revealed LAD in 48% of men and 41% of women, and LAH in 10% of men and 9% of women.
- Over 4 years, LAH remained stable, but new LAD cases emerged in men. Left ventricular hypertrophy (LVH) showed 50% reversibility, independent of axis deviation changes.
Impact:
- Findings suggest antihypertensive therapy may not reverse established ECG signs of cardiac strain like LAD or LAH.
- The study highlights the persistence of certain ECG abnormalities despite treatment.
- Understanding these ECG changes is vital for risk stratification and management of hypertensive heart disease.
Abstract:
The ECG's of 127 patients (81 men and 46 women) with uncomplicated essential hypertension were evaluated over a 4-year period of antihypertensive treatment. At the beginning of the study in 1973, 39 men (48%) showed ECG changes of left axis derivation (LAD) and 8 men (10%) a left anterior hemiblock (LAH), while 19 women (41) showed a LAD and 4 (9%) a LAH. During the course of the study no changes were noted in the 12 cases of LAH. However, two additional men developed signs of LAD in 1975/76 and one more in 1977/78. Men with LAH were somewhat older and women with LAH heavier in comparison to the total group. The combination of LAD and left ventricular hypertrophy (LVH) was evident in 9 men (11%) and 4 women (9%) at the beginning of the study, while 6 men (7%) and 1 woman showed a combination of LAH and LVH. Reversibility of LVH by ECG was observed in 10 patients (50%), but no concomitant changes in axis deviation were seen.