Effects of ramipril on left ventricular mass and function in cardiovascular patients with controlled blood pressure and with preserved left ventricular ejection fraction

Lonn, Eva; Shaikholeslami, R.; Yi, Qilong; Bosch, Jackie; Sullivan, Brian; Tanser, Paul H.; Magi, Alison; Yusuf, Salim

doi:10.1016/j.jacc.2003.10.073

Cited by 84 publications

(11 citation statements)

References 30 publications

(38 reference statements)

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“…30 Baseline left ventricular ejection fraction was similar (58% both in the vitamin E and placebo groups). During the period of 4 years, there was a mean (SD) decrease in left ventricular ejection fraction of 1.86% (0.58%) in the vitamin E group and 0.58% (0.61%) in the placebo group.…”

Section: Major Cardiovascular Eventsmentioning

confidence: 87%

Effects of Long-term Vitamin E Supplementation on Cardiovascular Events and Cancer

Lonn

Bosch²,

Yusuf³

et al. 2005

JAMA

1,061

160

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Context Experimental and epidemiological data suggest that vitamin E supplementation may prevent cancer and cardiovascular events. Clinical trials have generally failed to confirm benefits, possibly due to their relatively short duration.Objective To evaluate whether long-term supplementation with vitamin E decreases the risk of cancer, cancer death, and major cardiovascular events. Design, Setting, and PatientsA randomized, double-blind, placebo-controlled international trial (the initial Heart Outcomes Prevention Evaluation [HOPE] trial conducted between December 21, 1993, and April 15, 1999) of patients at least 55 years old with vascular disease or diabetes mellitus was extended (HOPE-The Ongoing Outcomes [HOPE-TOO]) between April 16, 1999, and May 26, 2003. Of the initial 267 HOPE centers that had enrolled 9541 patients, 174 centers participated in the HOPE-TOO trial. Of 7030 patients enrolled at these centers, 916 were deceased at the beginning of the extension, 1382 refused participation, 3994 continued to take the study intervention, and 738 agreed to passive follow-up. Median duration of follow-up was 7.0 years.Intervention Daily dose of natural source vitamin E (400 IU) or matching placebo.Main Outcome Measures Primary outcomes included cancer incidence, cancer deaths, and major cardiovascular events (myocardial infarction, stroke, and cardiovascular death). Secondary outcomes included heart failure, unstable angina, and revascularizations.Results Among all HOPE patients, there were no significant differences in the primary analysis: for cancer incidence, there were 552 patients (11.6%) in the vitamin E group vs 586 (12.3%) in the placebo group (relative risk [RR], 0.94; 95% confidence interval [CI], 0.84-1.06; P=.30); for cancer deaths, 156 (3.3%) vs 178 (3.7%), respectively (RR, 0.88; 95% CI, 0.71-1.09; P=.24); and for major cardiovascular events, 1022 (21.5%) vs 985 (20.6%), respectively (RR, 1.04; 95% CI, 0.96-1.14; P=.34). Patients in the vitamin E group had a higher risk of heart failure (RR, 1.13; 95% CI, 1.01-1.26; P=.03) and hospitalization for heart failure (RR, 1.21; 95% CI, 1.00-1.47; P=.045). Similarly, among patients enrolled at the centers participating in the HOPE-TOO trial, there were no differences in cancer incidence, cancer deaths, and major cardiovascular events, but higher rates of heart failure and hospitalizations for heart failure. ConclusionIn patients with vascular disease or diabetes mellitus, long-term vitamin E supplementation does not prevent cancer or major cardiovascular events and may increase the risk for heart failure.

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Section: Major Cardiovascular Eventsmentioning

confidence: 87%

Effects of Long-term Vitamin E Supplementation on Cardiovascular Events and Cancer

Lonn

Bosch²,

Yusuf³

et al. 2005

JAMA

1,061

160

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“…In patients with LVH and systolic hypertension, an angiotension receptor blockade (ARB) was superior to beta-blockers to prevent a variety of cardiovascular outcomes including HF (4). Further implicating the activation of the renal angiotensin aldosterone system as an upstream mechanism resulting in biochemical measures of myocyte loss and progression to HFrEF are findings from the HOPE study in normotensive vascular risk patients, where a higher dose of ramipril prevented a decrease in LVEF and increase in LV dimensions compared to either a low-dose or placebo (31). We suggest that our findings provide a basis for identifying older adults who could be targeted for HF prevention with renin-angiotensin-aldosterone system (RAAS) antagonism irrespective of whether they have hypertension.…”

Section: Discussionmentioning

confidence: 99%

Older Adults, “Malignant” Left Ventricular Hypertrophy, and Associated Cardiac-Specific Biomarker Phenotypes to Identify the Differential Risk of New-Onset Reduced Versus Preserved Ejection Fraction Heart Failure

Seliger

Lemos

Neeland

et al. 2015

JACC: Heart Failure

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Background The natural history of left ventricular hypertrophy (LVH) - an important risk factor for heart failure (HF) - is heterogeneous. Objectives We hypothesized that biomarkers of subclinical myocardial injury (high sensitive cardiac troponin T [hs cTnT]) and hemodynamic stress (NT-proBNP) would differentiate HF risk among older adults with LVH. Methods NT-proBNP and hs cTnT were measured at baseline and after 2–3 years in older adults without prior HF or MI in the Cardiovascular Health Study. LVH and LV ejection fraction (EF) were determined by echocardiography. HF events were adjudicated over a median 13.1 years and classified as preserved or reduced LVEF (HFpEF or HFrEF). Adjusted risk of HF by LVH and biomarker tertiles, and by LVH and longitudinal increase in each biomarker, was estimated using Cox regression. Results Prevalence of LVH was 12.5% among 2,347 participants with complete measures. Adjusted risk of HF (N=643 events) was roughly 3.8-fold higher among participants with LVH and in the highest biomarker tertile, compared to those with low biomarker levels without LVH (NT-proBNP: HR=3.78 [95% CI: 2.78, 5.15]; hs-cTnT: HR=3.86 [2.84, 5.26]). The adjusted risk of HFrEF was 7.8 times higher among those with the highest tertile of hs cTnT and LVH (HR=7.83 [4.43, 13.83]). Those with LVH and longitudinal increases in hs cTnT or NT-proBNP were roughly 3-fold more likely to develop HF – primarily HFrEF - compared to those without LVH and with stable biomarkers. Conclusions The combination of LVH with greater hs cTnT or NT-proBNP levels, and their longitudinal increase, identifies older adults at highest risk for symptomatic HF, especially HFrEF. These biomarkers may characterize sub-phenotypes in the transition from LVH to HF and suggest modifiable targets for prevention.

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“…Beta-blockers, ACE inhibitors, angiotensin receptor blockers, aldosterone antagonists, and calcium antagonists have been reported to have beneficial effects for LV diastolic function [4,18,19,20]. These drugs may effect LV diastolic function by several mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Bisoprolol Improves Echocardiographic Parameters of Left Ventricular Diastolic Function in Patients with Systemic Hypertension

İlgenli

Kılıçaslan²,

Kirilmaz³

et al. 2006

Cardiology

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Left ventricular (LV) diastolic dysfunction (LVD) is a common complication secondary to hypertension. It has been reported that bisoprolol is effective in reducing blood pressure and has beneficial cardiac effects in patients with hypertension. However, its effect on LV diastolic function has not been studied in detail. In this study, we sought to determine bisoprolol’s effect on left ventricle diastolic function. Data from 25 patients were statistically analyzed. Peaks E and A wave, E/A ratio, isovolumetric relaxation time and E wave deceleration time were measured echocardiographically. Doppler echocardiography measurements after bisoprolol treatment revealed an improvement in LV diastolic function. In conclusion, our results show that treatment with bisoprolol, improves echocardiographic parameters of LV diastolic function after 3 months of treatment.

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Effects of ramipril on left ventricular mass and function in cardiovascular patients with controlled blood pressure and with preserved left ventricular ejection fraction

Abstract: Ramipril has beneficial effects on LV structure and function in vascular patients with controlled BP and with preserved LVEF.

Cited by 84 publications

References 30 publications

Effects of Long-term Vitamin E Supplementation on Cardiovascular Events and Cancer

Effects of Long-term Vitamin E Supplementation on Cardiovascular Events and Cancer

Older Adults, “Malignant” Left Ventricular Hypertrophy, and Associated Cardiac-Specific Biomarker Phenotypes to Identify the Differential Risk of New-Onset Reduced Versus Preserved Ejection Fraction Heart Failure

Bisoprolol Improves Echocardiographic Parameters of Left Ventricular Diastolic Function in Patients with Systemic Hypertension

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