Title: Evolution of Left Ventricular Hypertrophy and Function During Long-Term Treatment of Systemic Hypertension With Enalapril
Abstract: The results of prospective studies indicate that the increased cardiovascular risk of patients with left ventricular (LV) hypertrophy appears to be reduced by reversal of their hypertrophy.[ 1 Koren MJ Ulin R Laragh JH Devereux RB Reduction of left ventricular mass during treatment of essential hypertension is associated with improved prognosis (abstr). Am J Hypertens. 1991; 4: 1A PubMed Google Scholar , 2 Yurenev AP Dyakonova HG Novikov ID Vitols A Pahl L Haynemann G Management of essential hypertension in patients with different degrees of left ventricular hypertrophy. Am J Hypertens. 1992; 5: 5182-5189 Google Scholar , 3 Muiesan ML Salvetti M Rizzoni D Castellano M Donato F Agabiti-Rosei E Association of change in left ventricular mass with prognosis during long-term antihypertensive treatment. J Hypertens. 1995; 13: 1091-1095 Crossref PubMed Scopus (342) Google Scholar ] A recent metanalysis of double-blind, randomized, controlled clinical studies of regression of LV hypertrophy in essential hypertension patients on antihypertensive drugs found that pretreatment LV mass, decline in blood pressure (BP), duration of drug treatment, and drug dose determined reduction in LV mass index.[ 4 Kranz I-W Ketelhut R Behr U Tonnesmann U Time course of reduction in left ventricular mass during long-term antihypertensive therapy. J Hum Hypertens. 1994; 8: 191-198 PubMed Google Scholar ] We recently reported[ 5 González-Juanatey JR Pose A Garcia-Acuña JM Castelo V Amaro A Calvo C Gil M Left ventricular systolic function after marked reduction of ventricular hypertrophy induced by 5 years' enalapril treatment. Eur Heart J. 1995; 16: 1981-1987 PubMed Google Scholar ] that 5-year treatment of a group of hypertensive patients with the angiotensin-converting enzyme inhibitor enalapril brought about both marked regression of LV hypertrophy and significant improvement in LV systolic function indexes, and that the improvement in function, as well as the reduced LV mass, was maintained during 8 weeks' suspension of treatment, despite the return of arterial BP to hypertensive values. The maintenance of good function in spite of increased afterload, which showed that myocardial fiber was in metabolically good condition, was interpreted as a sign that the antihypertensive treatment may have achieved true regression of myocardial remodelling, not just reduction of ventricular mass and size. In this study we report further follow up of the same patients after 6- and 7-year treatment, and include LV diastolic function data obtained by Doppler echocardiography during this period.
Publication Year: 1997
Publication Date: 1997-02-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 8
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