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One-year antihypertensive treatment with amlodipine: effects on 24-hour blood pressure and left ventricular anatomy
M Bignotti1, A M Grandi, G Gaudio
1Department of Internal Medicine and Medical Therapy, University of Pavia, Ospedale di Circolo, Varese, Italy.
Insights
Amlodipine treatment in hypertensive patients with left ventricular hypertrophy reduced left ventricular mass and improved diastolic function over one year. Systolic function remained unchanged, demonstrating amlodipine
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Left ventricular hypertrophy (LVH) is a common complication of hypertension.
- LVH is associated with impaired diastolic function and increased cardiovascular risk.
- Regression of LVH is a therapeutic goal in managing hypertension.
Purpose of the Study:
- To evaluate the effects of amlodipine on left ventricular (LV) morphology and function.
- To assess amlodipine's impact on hypertensive patients with pre-existing LVH.
Main Methods:
- 10 hypertensive patients with LVH received amlodipine (5 mg daily) for 1 year.
- M-mode echocardiograms and 24-hour ambulatory blood pressure monitoring were conducted at baseline and after treatment.
- LV mass, diastolic function (peak lengthening rate), and systolic function (peak shortening rate) were assessed.
Main Results:
- Amlodipine significantly reduced blood pressure without affecting heart rate.
- Left ventricular mass index decreased significantly in all patients.
- Diastolic function improved, with normalization in most patients with baseline impairment; systolic function remained unchanged.
Conclusions:
- One-year amlodipine treatment induces regression of left ventricular mass and improves diastolic function in hypertensive patients with LVH.
- Amlodipine does not alter systolic function in this patient group.
- The reduction in LV mass correlated with the decrease in blood pressure.
Abstract:
Using digitized M-mode echocardiograms and 24-hour noninvasive ambulatory blood pressure monitoring, we evaluated the effects of 1 year treatment with amlodipine on left ventricular morphology and function in 10 hypertensives with left ventricular hypertrophy. Echocardiograms and 24-hour blood pressure monitoring were performed after 3 weeks of wash-out and after 1 year of oral treatment with amlodipine (5 mg once daily). The therapy significantly lowered blood pressure, without changes in heart rate. Left ventricular mass decreased in all the patients and peak lengthening rate of left ventricular diameter, index of diastolic function, increased in all, with normalization in 5 of the 6 with basal diastolic impairment. Peak shortening rate of left ventricular diameter, index of systolic function, was normal in all at the basal evaluation and did not change after therapy. The percentage reduction of left ventricular mass index significantly correlated with percentage decrease of 24-hour and day-time systolic and diastolic blood pressure. Amlodipine is able to induce regression of left ventricular diastolic function and no changes of systolic function.