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[Effect of the treatment with amlodipine on left ventricular hypertrophy in hypertensive patients]
1Departamento de Medicina, Unidad de Hipertensión Arterial y Factores de Riesgo, Hospital Universitario Virgen Macarena, Sevilla.
Insights
Amlodipine effectively reduces blood pressure and significantly reverses left ventricular hypertrophy (LVH) in hypertensive patients. This study confirms amlodipine as a safe and beneficial treatment for mild to moderate hypertension.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular events, often associated with hypertension.
- Effective antihypertensive drugs should not only lower blood pressure but also mitigate LVH.
- Amlodipine, a calcium channel blocker, was investigated for its effects on LVH in hypertensive individuals.
Purpose of the Study:
- To evaluate the impact of amlodipine on left ventricular hypertrophy (LVH) in patients with mild to moderate hypertension.
- To assess the blood pressure-lowering efficacy and safety profile of amlodipine in this patient group.
Main Methods:
- A single-blind study involving 20 hypertensive patients (mild to moderate).
- A four-week placebo period followed by amlodipine treatment (5 mg/day, titrated to 10 mg/day if needed).
- Measurements included blood pressure, echocardiography (including septum and posterior wall thickness, dimensions, mass), and blood/urine analysis.
Main Results:
- Amlodipine significantly reduced systolic and diastolic blood pressure (p < 0.001).
- Significant reductions were observed in key echocardiographic parameters of LVH, including septum thickness, posterior wall thickness, left ventricular mass, and relative wall thickness (p < 0.015 for all).
- No significant changes were noted in blood parameters.
Conclusions:
- Amlodipine demonstrates a beneficial effect in reducing left ventricular hypertrophy (LVH).
- The drug is confirmed as an effective and safe treatment option for mild to moderate hypertension.
- Amlodipine addresses both blood pressure control and cardiac remodeling in hypertensive patients.
Background:
Left ventricular hypertrophy (LVH) is one of the physiopathological effects of hypertension and one of the main risk factors for sudden death, myocardial infarction and congestive heart failure. Drugs to treat hypertension must not only reduce blood pressure, but also modify the facts which lead to ventricular hypertrophy. This study has been designed to assess the effect of amlodipine, a calcium-antagonist, on LVH in hypertensive patients.
Methods:
20 hypertensive patients (mild to moderate, both sexes, mean age 45.0 yr) were included in a single-blind study. After an initial, four weeks placebo period, active treatment was given (amlodipine 5 mg a day). Dose titration was made after 4-8 weeks to 10 mg a day if necessary and continued until the end of the study. Systolic (SBP) and diastolic blood pressure (DBP), as well as pulse rate (PR) and adverse events were recorded at every visit. Blood and urine analysis, catecholamine, plasmatic renin activity and Mode M echocardiography were made at the beginning and the end of the study.
Results:
Only one patient was excluded. SBP and DBP showed a significantly fall (p < 0.001). In 80% of patients DBP fell under 90 mm Hg. Every echocardiographic parameter, but left ventricular diastolic dimension, showed significantly reductions at the end of the study: septum thickness (p = 0.001), posterior wall thickness (p = 0.001), left ventricular systolic dimension (p = 0.014), wall relative thickness (p = 0.015), shortening fraction (p = 0.009), left ventricular mass (p = 0.001) and corrected left ventricular mass (p = 0.001). Blood parameters did not modify.
Conclusions:
Amlodipine has a beneficial effect on LVH and also is an effective and safe drug to treat mild to moderate hypertension.