PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 9495620

Decrease of left ventricular mass is a clinically valuable intermediate end-point of antihypertensive treatment.

E Agabiti-Rosei
View original source ↗Export metadata ↓

Abstract

The presence of left ventricular hypertrophy (LVH) in hypertensive patients, recognized clinically by electrocardiography or echocardiography, is an adverse prognostic sign and a powerful predictor of cardiovascular morbidity and mortality, independent of blood pressure and other cardiovascular risk factors. Several pathophysiological changes accompany the myocytic growth and fibrosis that characterize hypertensive LVH and have been invoked to explain the association of LVH with increased cardiovascular risk. These include: impairment of diastolic function, and probably also of systolic performance, at least during exercise; reduced coronary blood flow reserve; predisposition to ventricular arrhythmias; alteration in cardiac autonomic nervous system activity. All these data have led to the opinion that regression of LVH should be a major goal in the treatment of hypertensive patients and might predict an improvement in prognosis.

Explore related subjects

Antihypertensive AgentsHeart VentriclesHumansHypertensionHypertrophy, Left VentricularOrgan SizePrognosisJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

E Agabiti-Rosei. 1997. Decrease of left ventricular mass is a clinically valuable intermediate end-point of antihypertensive treatment.. https://pubmed.ncbi.nlm.nih.gov/9495620/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed1999

Continuous infusion of epoprostenol improves the net balance between pulmonary endothelin-1 clearance and release in primary pulmonary hypertension.

BACKGROUND: Primary pulmonary hypertension results from progressive narrowing of the precapillary pulmonary vasculature. A variety of endothelial abnormalities have been identified, including a net reduction in pulmonary clearance of the vasoconstrictor and smooth muscle mitogen endothelin-1. In many patients, net pulmonary release of endothelin-1 is observed. Chronic infusions of epoprostenol (prostacyclin) improve functional capacity, survival, and hemodynamics in patients with advanced primary pulmonary hypertension. We hypothesized that the epoprostenol infusions, as compared with conventional therapy, might alter the abnormal pulmonary endothelin-1 homeostasis. METHODS AND RESULTS: Using a subset of patients from a larger randomized study comparing epoprostenol plus conventional therapy (n=11 in the present study) with conventional therapy alone (n=7 in the present study), we determined the ratio of plasma endothelin-1 levels in systemic arterial blood leaving the lung to levels in mixed venous blood entering the lung both before randomization and after 88 days of continuous therapy. There were no differences between the 2 groups before therapy, but by day 88, the epoprostenol-treated group had a greater proportion of patients (82%) with an arterial/venous ratio <1 than did the conventional therapy group, in which only 29% of patients had a ratio <1 (P<0.05). CONCLUSIONS: These results suggest that continuous epoprostenol therapy may have a beneficial effect on the balance between endothelin-1 clearance and release in many patients with primary pulmonary hypertension and may provide one explanation for the salutary effect of epoprostenol in this disease.

Antihypertensive Agents↗
PubMed1999

[An overview of hypertension studies with calcium antagonists].

Calcium antagonists are widely used in the treatment of hypertension. However, few endpoint studies with calcium antagonists have been done to prove reduction in hypertensive complications. Results of the STONE, SYST-EUR and SYST-CHINA studies show that long-acting calcium antagonists are effective compared to placebo, especially in patients with isolated systolic hypertension and diabetes. Ongoing prospective and randomized trials like STOP II, INSIGHT, NORDIL, ALLHAT and ASCOT will clarify whether calcium antagonists are more effective than well-proven diuretics and betablockers. ASCOT will test the hypothesis that amlodipine is more efficacious than atenolol in preventing cardiac complications in 18,000 hypertensive patients with high coronary risk including diabetes (among them, 2,000 in Norway). The study is also randomizing the patients in a factorial design to either atorvastatin or placebo, testing the so-called lipid hypothesis.

Antihypertensive Agents↗