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Related Experiment Videos

Comparison of enalapril versus nifedipine to decrease left ventricular hypertrophy in systemic hypertension (the

R B Devereux1, B Dahlof, D Levy

  • 1Department of Medicine, The New York Hospital-Cornell Medical Center, New York 10021, USA.

The American Journal of Cardiology
|July 1, 1996
PubMed
Summary

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The PRESERVE study found enalapril more effectively reduced left ventricular (LV) mass compared to nifedipine. This reduction in LV mass may lower cardiovascular event risk, independent of blood pressure changes.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Research

Background:

  • Essential hypertension is often associated with increased left ventricular (LV) mass.
  • LV mass is a prognostic indicator for cardiovascular events.
  • Enalapril and nifedipine are common antihypertensive medications with differing effects on cardiac structure.

Purpose of the Study:

  • To compare the efficacy of enalapril versus nifedipine gastrointestinal treatment system (GITs) in reducing LV mass.
  • To determine if LV mass reduction, independent of blood pressure lowering, impacts cardiovascular event risk.
  • To assess the impact of enalapril and nifedipine on LV structure, wall motion, and diastolic filling.

Main Methods:

  • Prospective, randomized, double-blind trial involving 480 patients with essential hypertension and increased LV mass.

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  • Echocardiography used at baseline, 6 months, and 12 months to assess LV mass and diastolic function.
  • Long-term follow-up (3 years post-echocardiographic trial) to monitor cardiovascular events.

    • Main Results:

    • Enalapril demonstrated a statistically significant greater reduction in LV mass compared to nifedipine GITs.
    • Enalapril also showed greater normalization of diastolic filling patterns.
    • The study is powered to detect prognostically meaningful differences in LV mass reduction.

    Conclusions:

    • Enalapril is more effective than nifedipine GITs in reducing LV mass in hypertensive patients.
    • The reduction in LV mass achieved by enalapril may translate to a reduced risk of cardiovascular events.
    • Further long-term follow-up is ongoing to confirm the impact on cardiovascular morbidity and mortality.