Effect of Therapy on Left Ventricular Function in Hypertension

Khatri, Ibrahim M.; Gottdiener, John S.; Notargiacomo, Aldo; Freis, Edward D.

doi:10.1042/cs059435s

Cited by 20 publications

(2 citation statements)

References 12 publications

(8 reference statements)

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“…Echocardiographic studies have not shown a decrease in systolic function with LV mass reduction [11]. Also, midwall fractional shortening as a method of assessing myocardial contractibility did not show adverse effects on systolic function with reduction in LV mass [12].…”

Section: Risks Associated With Left Ventricle Hypertrophy Reductionmentioning

confidence: 98%

Left ventricular hypertrophy: Unresolved issues

Schoenberger¹

1999

Current Science Inc

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Section: Risks Associated With Left Ventricle Hypertrophy Reductionmentioning

confidence: 98%

Left ventricular hypertrophy: Unresolved issues

Schoenberger¹

1999

Current Science Inc

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“…It is well known that angiotensin II impairs myocardial relaxation, [163] therefore, inhibition of angiotensin II may be expected to improve left ventricular filling. [115,169] However, it has to be considered that in these trials left ventricular filling was normal at baseline, thus, left ventricular filling would not be expected to improve.…”

Section: Effects On Diastolic Functionmentioning

confidence: 99%

Effects of Antihypertensive Agents on the Left Ventricle

Dı́ez

González

López

et al. 2001

American Journal of Cardiovascular Drugs

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Hypertensive heart disease (HHD) is characterized by left ventricular hypertrophy (LVH), alterations of cardiac function, and coronary flow abnormalities. LVH is an independent cardiovascular risk factor related to cardiovascular complications in patients with hypertension. Therefore, a decrease in left ventricular mass is a therapeutic goal in these patients. The effect of the different antihypertensive agents on LVH regression has been studied in nearly 500 clinical trials. Most studies conclude that there is regression of LVH after significant decrease in blood pressure with most commonly prescribed antihypertensive agents. However, the ability to regress LVH is different between antihypertensive drug classes. ACE inhibitors and calcium channel antagonists are more potent in reducing left ventricular mass than beta-blockers, with diuretics falling in the intermediate group. Recent data suggest that angiotensin AT(1) receptor antagonists reduce left ventricular mass to a similar extent as ACE inibitors or calcium channel antagonists. Although a large number of studies have established that reversal of LVH decreases the occurrence of adverse cardiovascular events in patients with hypertension, the hypothesis that LVH regression is beneficial has not yet been conclusively proven. On the other hand, the time has come to revisit the current management of HHD simply focused on controlling blood pressure and reducing left ventricular mass. In fact, it is necessary to develop new approaches aimed to repair myocardial structure and protect myocardial perfusion and function and, in doing so, to reduce in a more effective manner, adverse risk associated with HHD. The identification of genes involved in both the process of HHD and the response to therapy may be critical for the development of these new approaches. This article will review briefly the available data on the effects of antihypertensive agents on HHD. In addition, the emerging new concepts on the pharmacology of hypertensive myocardial remodeling and the pharmacogenetic basis of the treatment of HHD will be also considered.

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Regression of left ventricular mass in systemic hypertension

Georgiou

Brundage

1992

Clinical Cardiology

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Summary:The importance of treatment in systemic hypertension and cardiovascular morbidity and mortality has been established. Although systemic hypertension is the most important factor in the pathogenesis of left ventricular hypertrophy, other factors such as catecholamines and renin-angiotensin system may be involved. Increased left ventricular mass causes reduction in coronary reserve and may lead to acute ischemic events. Equally efficacious antihypertensive agents may have diverse effects on left ventricular hypertrophy and left ventricular function. New tomographic techniques with improved spatial resolution are emerging in the evaluation of left ventricular mass and may therefore provide better assessment of changes in left ventricular mass. With improved measures of left ventricular mass the question as to whether regression of left ventricular mass provides an additional benefit beyond control of blood pressure in hypertensive individuals may be finally answered.

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Effect of Therapy on Left Ventricular Function in Hypertension

Cited by 20 publications

References 12 publications

Left ventricular hypertrophy: Unresolved issues

Left ventricular hypertrophy: Unresolved issues

Effects of Antihypertensive Agents on the Left Ventricle

Regression of left ventricular mass in systemic hypertension

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