Reversibility of left ventricular hypertrophy by antihypertensive drugs

Opposite associations of circulating aldosterone and atrial natriuretic peptide with left ventricular diastolic function in essential hypertension

“…A recent meta-analysis which was restricted to randomised comparative studies revealed that there is as yet no convincing evidence that anti-hypertensive agents which suppress the renin-angiotensin-system reduce left ventricular mass to a greater extent than other first line drugs to which they were directly compared. 29 An inverse relationship of left ventricular mass and wall thickness with plasma atrial natriuretic peptide might have been expected based on its antigrowth and antimitogenic properties, but this was not observed in the present study or in published reports in normal subjects, 24 hypertensive patients, 22,24,27 both combined, 25 or in patients with congestive heart failure due to diastolic dysfunction. 26 Dessì-Fulgheri et al 25 and Schroeder et al 22 even observed a positive association between left ventricular mass index and atrial natriuretic peptide, which remained significant after controlling for significant confounders in the latter study.…”

Opposite associations of circulating aldosterone and atrial natriuretic peptide with left ventricular diastolic function in essential hypertension

“…A recent meta-analysis which was restricted to randomised comparative studies revealed that there is as yet no convincing evidence that anti-hypertensive agents which suppress the renin-angiotensin-system reduce left ventricular mass to a greater extent than other first line drugs to which they were directly compared. 29 An inverse relationship of left ventricular mass and wall thickness with plasma atrial natriuretic peptide might have been expected based on its antigrowth and antimitogenic properties, but this was not observed in the present study or in published reports in normal subjects, 24 hypertensive patients, 22,24,27 both combined, 25 or in patients with congestive heart failure due to diastolic dysfunction. 26 Dessì-Fulgheri et al 25 and Schroeder et al 22 even observed a positive association between left ventricular mass index and atrial natriuretic peptide, which remained significant after controlling for significant confounders in the latter study.…”

Risk Factor-induced Cardiovascular Remodeling and the Effects of Angiotensin-Converting Enzyme Inhibitors

“…[86][87][88][89][90][91][92][93] In a meta-analysis assessing the effects of antihypertensive therapy on LVH, which included a total of 2357 patients, the absolute reductions in LV mass were 44.7g (ACE inhibitors), 22.8 g (b-adrenoceptor antagonists [beta blockers]), 26.9 g (CCAs), and 21.4 g (diuretics). 94 Although other analyses of better-quality trials did not confirm the superiority of ACE inhibitors compared with long-acting CCAs, 95,96 these findings are in agreement with those of the Veterans' Administration Trial, which provided suggestive evidence of a greater LVH regression by a diuretic or an ACE inhibitor than a CCA. 88 A more recent meta-analysis of randomized, doubleblind trials compared the effects of various antihypertensive therapies, including ACE inhibitors, CCAs, and AT2-receptor antagonists, on LV mass in a total of 3767 patients with essential hypertension.…”

Efficacy of Different Drug Classes Used to Initiate Antihypertensive Treatment in Black Subjects

“…This analysis revealed that thiazides, ␤-blockers, calcium channel blockers,and ACE inhibitors reduced left ventricular mass to the same degree as the 3 other classes statistically combined, and that ACE inhibitors were not superior to calcium channel blockers. 21 Our study showed a significant decrease in left ventricular mass index at 4 months paralleling the decline in BP, with no differences between the treat-ment groups. This observation suggests that BP control rather than drug class is the predominant factor determining left ventricular mass regression.…”

“…Two research groups 19,20 have suggested that to reduce left ventricular hypertrophy ACE inhibitors would be most efficient. However, a third meta-analyst 21 considered only prospective, randomized, and properly controlled comparative studies. This analysis revealed that thiazides, ␤-blockers, calcium channel blockers,and ACE inhibitors reduced left ventricular mass to the same degree as the 3 other classes statistically combined, and that ACE inhibitors were not superior to calcium channel blockers.…”

Opposite associations of circulating aldosterone and atrial natriuretic peptide with left ventricular diastolic function in essential hypertension

“…A recent meta-analysis which was restricted to randomised comparative studies revealed that there is as yet no convincing evidence that anti-hypertensive agents which suppress the renin-angiotensin-system reduce left ventricular mass to a greater extent than other first line drugs to which they were directly compared. 29 An inverse relationship of left ventricular mass and wall thickness with plasma atrial natriuretic peptide might have been expected based on its antigrowth and antimitogenic properties, but this was not observed in the present study or in published reports in normal subjects, 24 hypertensive patients, 22,24,27 both combined, 25 or in patients with congestive heart failure due to diastolic dysfunction. 26 Dessì-Fulgheri et al 25 and Schroeder et al 22 even observed a positive association between left ventricular mass index and atrial natriuretic peptide, which remained significant after controlling for significant confounders in the latter study.…”

Risk Factor-induced Cardiovascular Remodeling and the Effects of Angiotensin-Converting Enzyme Inhibitors

“…[86][87][88][89][90][91][92][93] In a meta-analysis assessing the effects of antihypertensive therapy on LVH, which included a total of 2357 patients, the absolute reductions in LV mass were 44.7g (ACE inhibitors), 22.8 g (b-adrenoceptor antagonists [beta blockers]), 26.9 g (CCAs), and 21.4 g (diuretics). 94 Although other analyses of better-quality trials did not confirm the superiority of ACE inhibitors compared with long-acting CCAs, 95,96 these findings are in agreement with those of the Veterans' Administration Trial, which provided suggestive evidence of a greater LVH regression by a diuretic or an ACE inhibitor than a CCA. 88 A more recent meta-analysis of randomized, doubleblind trials compared the effects of various antihypertensive therapies, including ACE inhibitors, CCAs, and AT2-receptor antagonists, on LV mass in a total of 3767 patients with essential hypertension.…”

Efficacy of Different Drug Classes Used to Initiate Antihypertensive Treatment in Black Subjects

“…This analysis revealed that thiazides, ␤-blockers, calcium channel blockers,and ACE inhibitors reduced left ventricular mass to the same degree as the 3 other classes statistically combined, and that ACE inhibitors were not superior to calcium channel blockers. 21 Our study showed a significant decrease in left ventricular mass index at 4 months paralleling the decline in BP, with no differences between the treat-ment groups. This observation suggests that BP control rather than drug class is the predominant factor determining left ventricular mass regression.…”

“…Two research groups 19,20 have suggested that to reduce left ventricular hypertrophy ACE inhibitors would be most efficient. However, a third meta-analyst 21 considered only prospective, randomized, and properly controlled comparative studies. This analysis revealed that thiazides, ␤-blockers, calcium channel blockers,and ACE inhibitors reduced left ventricular mass to the same degree as the 3 other classes statistically combined, and that ACE inhibitors were not superior to calcium channel blockers.…”

Opposite associations of circulating aldosterone and atrial natriuretic peptide with left ventricular diastolic function in essential hypertension

“…A recent meta-analysis which was restricted to randomised comparative studies revealed that there is as yet no convincing evidence that anti-hypertensive agents which suppress the renin-angiotensin-system reduce left ventricular mass to a greater extent than other first line drugs to which they were directly compared. 29 An inverse relationship of left ventricular mass and wall thickness with plasma atrial natriuretic peptide might have been expected based on its antigrowth and antimitogenic properties, but this was not observed in the present study or in published reports in normal subjects, 24 hypertensive patients, 22,24,27 both combined, 25 or in patients with congestive heart failure due to diastolic dysfunction. 26 Dessì-Fulgheri et al 25 and Schroeder et al 22 even observed a positive association between left ventricular mass index and atrial natriuretic peptide, which remained significant after controlling for significant confounders in the latter study.…”

Risk Factor-induced Cardiovascular Remodeling and the Effects of Angiotensin-Converting Enzyme Inhibitors

“…[86][87][88][89][90][91][92][93] In a meta-analysis assessing the effects of antihypertensive therapy on LVH, which included a total of 2357 patients, the absolute reductions in LV mass were 44.7g (ACE inhibitors), 22.8 g (b-adrenoceptor antagonists [beta blockers]), 26.9 g (CCAs), and 21.4 g (diuretics). 94 Although other analyses of better-quality trials did not confirm the superiority of ACE inhibitors compared with long-acting CCAs, 95,96 these findings are in agreement with those of the Veterans' Administration Trial, which provided suggestive evidence of a greater LVH regression by a diuretic or an ACE inhibitor than a CCA. 88 A more recent meta-analysis of randomized, doubleblind trials compared the effects of various antihypertensive therapies, including ACE inhibitors, CCAs, and AT2-receptor antagonists, on LV mass in a total of 3767 patients with essential hypertension.…”

Efficacy of Different Drug Classes Used to Initiate Antihypertensive Treatment in Black Subjects

“…This analysis revealed that thiazides, ␤-blockers, calcium channel blockers,and ACE inhibitors reduced left ventricular mass to the same degree as the 3 other classes statistically combined, and that ACE inhibitors were not superior to calcium channel blockers. 21 Our study showed a significant decrease in left ventricular mass index at 4 months paralleling the decline in BP, with no differences between the treat-ment groups. This observation suggests that BP control rather than drug class is the predominant factor determining left ventricular mass regression.…”

“…Two research groups 19,20 have suggested that to reduce left ventricular hypertrophy ACE inhibitors would be most efficient. However, a third meta-analyst 21 considered only prospective, randomized, and properly controlled comparative studies. This analysis revealed that thiazides, ␤-blockers, calcium channel blockers,and ACE inhibitors reduced left ventricular mass to the same degree as the 3 other classes statistically combined, and that ACE inhibitors were not superior to calcium channel blockers.…”