Skip to main content
SpringerLink
Log in

Antihypertensive Medications and Diastolic Dysfunction Progression in an African American Population

  • Original Article
  • Published:
High Blood Pressure & Cardiovascular Prevention Aims and scope Submit manuscript

Abstract

Background

There have been no studies examining the association between antihypertensive medications and progression of diastolic dysfunction. The purpose of this study is to determine whether there is an association between class of antihypertensive medication and diastolic dysfunction progression in an African American population.

Methods

A retrospective cohort study of African American patients with at least two echocardiograms demonstrating diastolic dysfunction drawn from an echocardiogram database at an academic medical center. The main outcome measures were change in diastolic function grade as a function of time and association with hypertension medication classification.

Results

There were 96 African American patients in the database with 2 or more echocardiograms demonstrating diastolic dysfunction; representing 302 echocardiograms. The mean time between echocardiograms was 2.6 years. The mean age was 64.2 (±10.1) years, 78 % were women, and mean BMI 31.2 (±7.4) kg/m2. The majority of subjects had Grade I diastolic dysfunction at their initial examination [N = 87 (90.6 %)]. Approximately 22.9 % (n = 22) of the study cohort demonstrated diastolic dysfunction progression. In multivariate analysis use of calcium channel blockers (CCB) was protective against diastolic dysfunction progression (OR for CCB users vs. non-users 0.28, 95 % confidence interval, 0.09–0.90, p < 0.05).

Conclusions

These findings suggest that use of calcium channel blockers may have a protective effect against progression of diastolic dysfunction among African American patients. Further studies are required to confirm these findings and identify specific factors that can mediate disease progression among African American individuals with hypertension, who face substantial risk of complications such as diastolic heart failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ferdinand K, Armani A. The management of hypertension in African Americans. Crit Pathw Cardiol. 2007;6:67–71.

    Article  PubMed  Google Scholar 

  2. Garg N, Senthilkumar A, Nusair M, et al. Heart Failure with a normal left ventricular ejection fraction: epidemiology, pathophysiology, diagnosis and management. Am J Med Sci. 2013;346:129–36.

    Article  PubMed  Google Scholar 

  3. Shah S. Heart failure with preserved ejection fraction in African Americans. Ethn Dis. 2012;22:432–8.

    PubMed  Google Scholar 

  4. Aljaroudi W, Thomas J, Rodriguez L. et al. Prognostic Value of diastolic dysfunction: a state of the art review. Cardiol Rev. 2014;22:79–90.

    Article  PubMed  Google Scholar 

  5. Von Lueder T, Krum H. RAAS inhibitors and cardiovascular protection in large scale trials. Cardiovasc Drugs Ther. 2013;27:171–9.

    Article  CAS  Google Scholar 

  6. James P, Oparil S, Carter B, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC-8). JAMA. 2014;311:507–20.

    Article  CAS  PubMed  Google Scholar 

  7. Sussman J, Vijan S, Hayward R. Using benefit-based tailored treatment to improve the use of antihypertensive medications. Circulation. 2013;128:2309–17.

    Article  CAS  PubMed  Google Scholar 

  8. Prendergast H, Dudley S, Kane J, et al. Progression of left ventricular diastolic dysfunction in ethnic minorities. High Blood Press Cardiovasc Prevention. 2013. [Epub ahead of print].

  9. Recommendations for Chamber Quantification: A Report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.

  10. Flack J, Sica D, Bakris G, et al. Management of high blood pressure in blacks: an update of the international society on hypertension in blacks consensus statement. Hypertension. 2010;56:780–800.

    Article  CAS  PubMed  Google Scholar 

  11. Ozkor M, Rahman A, Murrow J, et al. Differences in vascular nitric oxide and endothelium-derived hyperpolarizing factor bioavailability in blacks and whites. Arterioscler Thromb Vasc Biol. 2014;34:1320-27.

    Article  CAS  PubMed  Google Scholar 

  12. Ding Y, Vaziri N. Nifedipine and diltiazem but not verapamil up-regulate endothelial nitric-oxide synthase expression. JPET. 2000;292:606–9.

    CAS  Google Scholar 

  13. Ding Y, Vaziri N. Calcium channel blockade enhances nitric oxide synthase expression by cultured endothelial cells. Hypertension. 1998;32:718–23.

    Article  CAS  PubMed  Google Scholar 

  14. Tabrizchi R. Amlodipine and endothelial nitric oxide synthase activity. Cardiovasc Res. 2003;53:807–9.

    Article  Google Scholar 

  15. Brener S, Ivanc T, Poloszczuk R, et al. Antihypertensive therapy and regression of coronary artery disease: insights from the Comparison of Amlodipine versus Enalapril to Limit Occurrences of Thrombosis(CAMELOT) and Norvasc for Regression of Manifest Atherosclerotic Lesions by Intravascular Sonographic Evaluation (NORMALISE) trials. Am Heart J. 2006;15:1059–63.

    Article  Google Scholar 

  16. Wood P, Piran S, Liu P. Diastolic heart failure: progress, treatment challenges, and prevention. Can J Cardiol. 2011;27:302–10.

    Article  PubMed  Google Scholar 

  17. Gradman A, Basile J, Carter B, et al. Combination therapy in hypertension. JASH. 2010;4:90–8.

    CAS  PubMed  Google Scholar 

  18. Bruasoulis A, Agarwal V, Tousoulis D, et al. Effects of antihypertensive treatment in patients over 65 years of age: a meta-analysis of randomized controlled studies. Heart. 2014;100:317–23.

    Article  Google Scholar 

  19. Joffe S, Phillips R. Treating hypertension in patients with left ventricular dysfunction: hitting the fairway and avoiding the rough. Curr Heart Fail Rep. 2013;10:157–64.

    Article  PubMed  Google Scholar 

  20. Glezeva N, Baugh J. Role of inflammation in the pathogenesis of heart failure with preserved ejection fraction and its potential as a therapeutic target. Heart Fail Rev. 2013. Sept 5. [Epub ahead of print].

  21. Glezeva N, Baugh J. Role of inflammation in the pathogenesis of heart failure with preserved ejection fraction and its potential as a therapeutic target. Heart Fail Rev. 2013. Sept 5. [Epub ahead of print].

Download references

Acknowledgments

The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR000050. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, University of Illlinois Hospital & Health Sciences System, 808 S. Wood Rm 471-H, Chicago, IL, 60612, USA

    Heather M. Prendergast, E. Bradshaw Bunney, Jared Marcucci & Rasheed Sanyaolu

  2. Section of Cardiology, Brown University, Providence, RI, USA

    Samuel Dudley

  3. Department of Kinesiology & Nutrition, University of Illinois at Chicago, 1919 W. Taylor St. MC-517, AHSB Rm. 646, Chicago, IL, 60612, USA

    Michael Brown

  4. Institute for Minority Health, University of Illinois at Chicago, 1819 W. Polk St, Suite 246, Chicago, IL, 60612, USA

    Martha Daviglus

  5. Rush Medical Center, Chicago, USA

    John Kane

Authors
  1. Heather M. Prendergast
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samuel Dudley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martha Daviglus
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John Kane
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Bradshaw Bunney
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jared Marcucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rasheed Sanyaolu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Heather M. Prendergast.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Prendergast, H.M., Dudley, S., Brown, M. et al. Antihypertensive Medications and Diastolic Dysfunction Progression in an African American Population. High Blood Press Cardiovasc Prev 21, 269–274 (2014). https://doi.org/10.1007/s40292-014-0064-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40292-014-0064-1

Keywords

Search

Navigation