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Influence of left ventricular mass regression on cardiac function in hypertensive elderly individuals

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Summary

A randomized, double-blind placebo controlled trial was conducted to compare the ability of verapamil and atenolol to induce regression of left ventricular mass in elderly hypertensive patients and the effects of regression on left ventricular filling, ejection fraction, and cardiac volumes. Forty-two individuals over 60 years of age were enrolled in the protocol. Eight of 21 patients assigned to atenolol and 18 to 21 assigned to verapamil achieved blood pressure control with single-agent therapy (p < 0.05). The addition of chlorthalidone resulted in blood pressure control in the three remaining assigned to verapamil and in ten of the remaining patients assigned to atenolol. In the verapamil group left ventricular mass index decreased from 104 ± 5 to 85 ± 5 g/M2, while it was unchanged in the atenolol patients (109 ± 9 to 112 ± 10 g/M2). In the patients in whom the left ventricular mass regressed, the peak filling rate increased from 2.42 ± 0.2 to 3.31 ± 0.4 EDV/s, while it did not change in the patients who did not experience regression. Furthermore, ejection fraction and cardiac output were maintained in patients who had regression, both at rest and during mild upright bicycle exercise.

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References

  1. 1.

    Schulman SP, Weiss JL, Becker LC, Gottlieb SO, Woodruff KM, Weisfeldt ML, Gerstenblith G (1990) The effects of antihypertensive therapy on left ventricular mass in elderly patients. N Engl J Med 19: 1350–56

  2. 2.

    Kannel WB (1976) Some lessons in cardiovascular epidemiology from Framingham. Am J Cardiol 37: 269–82

  3. 3.

    Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1989) Left ventricular mass and incidence of coronary heart disease in an elderly cohort: the Framingham Heart Study. Ann Intern Med 110: 101–07

  4. 4.

    Lorell BH, Grossman W (1987) Cardiac hypertrophy: The consequences for diastole. J Am Coll Cardiol 9: 1189–93

  5. 5.

    Hirota Y (1980) A clinical study of left ventricular relaxation. Circulation 62: 756–63

  6. 6.

    Smith VE, Schulman P, Karimeddini MK, White WB, Meeran MK, Katz AM (1985) Rapid ventricular filling in left ventricular hypertrophy. II. Pathologic hypertrophy. J Am Coll Cardiol 5: 869–74

  7. 7.

    Hanrath P, Methey DG, Siegert R, Bleifeld W (1980) Left ventricular relaxation and filling pattern in different forms of left ventricular hypertrophy: An echocardiographic study. Am J Cardiol 45: 15–23

  8. 8.

    Spech MM, Ferrario CM, Tarazi RC (1980) Cardiac pumping ability following reversal of hypertrophy and hypertension in spontaneously hypertensive rats. Hypertension 2: 75–82

  9. 9.

    Wyatt HL, Heng MK, Meerbaum S (1979) Cross-sectional echocardiography. I. Analysis of mathematical models for quantifying mass of the left ventricle in dogs. Circulation 60: 1104–13

  10. 10.

    Plotnick GD, Kahn B, Rogers WJ, Fisher ML, Becker LC (1988) Effect of postural changes, nitroglycerin and verapamil on diastolic ventricular function as determined by radionuclide angiography in normal subjects. J Am Coll Cardiol 12: 121–9

  11. 11.

    Links JM, Becker LC, Shindledecker JG, et al. (1982) Measurement of absolute left ventricular volume from gated blood pool studies. Circulation 65: 82–91

  12. 12.

    Messerli FH, Sundgaard-Riise K, Ventura HO, Dunn FG, Glade LB, Frohlich ED (1983) Essential hypertension in the elderly: haemodynamics, intravascular volume, plasma renin activity, and circulating catecholamine levels. Lancet II: 983–6

  13. 13.

    Lakatta EG, Gerstenblith G, Angell CS, Shock NW, Weisfeldt ML (1975) Diminished inotropic response to catecholamines in aged myocardium. Circ Res 36: 262–269

  14. 14.

    Sau F, Chershi A, Seguro C (1982) Reversal of left ventricular hypertrophy after treatment of hypertension by atenolol for one year. Clin Sci 63 [Suppl 8]: 367s-369s

  15. 15.

    Dunn FG, Ventura HO, Messerli FH, Kobrin I, Frohlich ED (1987) Time course of regression of left ventricular hypertrophy in hypertensive patients treated with atenolol. Circulation 76: 254–8

  16. 16.

    Lakatta EG, Gerstenblith G, Angell CS, Shock NW, Weisfeldt ML (1975) Prolonged contraction duration in aged myocardium. J Clin Invest 55: 61–8

  17. 17.

    Gerstenblith G, Frederiksen J, Yin FC, Fortuin NJ, Lakatta EG, Weisfeldt ML (1977) Echocardiographic assessment of a normal adult aging population. Circulation 56: 273–8

  18. 18.

    Froehlich JP, Lakatta EG, Beard E, Spurgeon HA, Weisfeldt ML, Gerstenblith G (1978) Studies of sarcoplasmic reticulum function and contraction duration in young adult and aged rat myocardium. J Mol Cell Cardiol 10: 427–438

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Supported in part by a contract from the National Institute on Aging (AG 89-0809) and the Knoll Pharmaceutical Company

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Gerstenblith, G., Schulman, S.P. Influence of left ventricular mass regression on cardiac function in hypertensive elderly individuals. Eur J Clin Pharmacol 39, S25–S28 (1990). https://doi.org/10.1007/BF03216271

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Key words

  • Hypertension
  • aging
  • left ventricular mass
  • verapamil
  • atenolol