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Evolution of left ventricular hypertrophy and function during long-term treatment of systemic hypertension with
J R González-Juanatey1, A Pose Reino, A V Román
1Cardiology Department and Hypertension Unit, Complejo Hospitalario Universitario, La Coruna, Spain.
Insights
Enalapril treatment effectively reduced left ventricular hypertrophy in hypertensive patients over five years. Stopping the medication caused blood pressure to rise and impaired heart relaxation, highlighting the drug's sustained benefits.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension is a major risk factor for cardiovascular disease, often leading to left ventricular hypertrophy (LVH).
- Angiotensin-converting enzyme inhibitors like enalapril are commonly used to manage hypertension and its cardiac consequences.
Purpose of the Study:
- To evaluate the long-term effects of enalapril on left ventricular hypertrophy in hypertensive patients.
- To assess the reversibility of cardiac changes upon temporary cessation of enalapril treatment.
Main Methods:
- A longitudinal study involving hypertensive patients treated with enalapril.
- Echocardiographic and blood pressure measurements were taken over a 7-year period.
- Assessment of cardiac function, including isovolumic relaxation time and ventricular filling, before and after temporary treatment suspension.
Main Results:
- Continued enalapril treatment led to a steady reduction in left ventricular hypertrophy over 5 years, normalizing structural parameters.
- No further reduction in LVH was observed in the subsequent 2 years of treatment.
- Temporary suspension of enalapril after 5 years resulted in increased blood pressure and impaired LV relaxation, indicated by altered isovolumic relaxation time and E wave deceleration.
Conclusions:
- Sustained enalapril therapy effectively reverses left ventricular hypertrophy in hypertensive patients.
- The beneficial cardiac effects of enalapril are reversible upon treatment discontinuation, underscoring the need for long-term management.
Abstract:
Continued treatment of hypertensive patients with enalapril reduced left ventricular (LV) hypertrophy steadily over a period of 5 years (by which time gross structural parameters were normal) and produced no further reduction during the following 2 years. Temporary suspension of treatment after 5-year follow-up gave rise to an increase in blood pressure, and to deterioration of LV isovolumic relaxation time and deceleration of the ventricular filling E wave, both of which chiefly reflect the active relaxation of the ventricle.