Long-term and Strict Blood Pressure Lowering by Imidapril Reverses Left Ventricular Hypertrophy in Patients with Essential Hypertension: an Evaluation Using a Novel Indicator of Burden on the Left Ventricle.
From: Second Department of Internal Medicine, Gifu University School of Medicine, Yanagido 1-1, Gifu 501-1911, Japan.
Hypertension research : official journal of the Japanese Society of Hypertension
- Publish Date: Feb 2006
- ISSN: 0916-9636
- Volume: 29
- Issue: 2
- Pages: 89-94
- Medium: Print
- Language: English
- Citation (JAMA): Takahashi Masahiko, Minatoguchi Shinya, Nishigaki Kazuhiko, et al. Long-term and Strict Blood Pressure Lowering by Imidapril Reverses Left Ventricular Hypertrophy in Patients with Essential Hypertension: an Evaluation Using a Novel Indicator of Burden on the Left Ventricle.. Hypertens. Res. Feb 2006;29:89-94
Abstract
Left ventricular hypertrophy is an independent risk factor for cardiovascular disease. We evaluated the effect of long-term and strict antihypertensive therapy with and without the angiotensin-converting enzyme inhibitor (ACEI) imidapril on left ventricular hypertrophy using a novel indicator of chronic burden on the left ventricle, the area under the blood pressure curve x the duration of high blood pressure (AUSBP and AUDBP), in patients with essential hypertension. The patients were divided into 2 groups: an ACEI group, in which imidapril was used in addition to antihypertensive drugs such as Ca channel blockers, beta-blockers, diuretics or angiotensin II antagonist; and a non-ACEI group, in which Ca channel blockers and diuretics were used. Systolic and diastolic blood pressures (SBP and DBP) were both maintained at below 140 and 90 mmHg, respectively, for 2 years. There was no significant difference in the left ventricular mass (LVM) assessed by echocardiography at baseline and that at 2 years of follow-up in the non-ACEI group. However, the LVM in the ACEI group was significantly decreased at 2 years of follow-up as compared to that at the baseline visit. There was no difference in the mean AUSBP and AUDBP between the ACEI and non-ACEI groups. Changes in the LVM were not correlated with the AUSBP or AUDBP in both the ACEI and non-ACEI groups. These findings suggest that the decrease in the LVM in the ACEI group was mediated through mechanisms other than the blood pressure lowering-effect and that AUSBP and AUDBP may be novel indicators of the long-term burden on the left ventricle.
Mesh Headings (Keywords): Aged, Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, Female, Heart Ventricles, Humans, Hypertension, Hypertrophy, Left Ventricular, Imidazolidines, Male, Middle Aged, Prospective Studies, Time Factors
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