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From Ospedale Generale Regionale Raffaello Silvestrini, Area Omogenea di
Cardiologia e Medicina, Perugia (P.V., C.B., A.C., R.G., I.Z., C.P.); Ospedale
Beato G. Villa, Città della Pieve (G.S.); and DIMISEM Università
di Perugia (G.R.), Italy. Presented in part at the Twelfth Scientific Meeting
of the American Society of Hypertension, San Francisco, Calif, May
27–31, 1996. Correspondence to Dr Paolo Verdecchia, Ospedale Generale
Regionale R. Silvestrini, Area Omogenea di Cardiologia e Medicina,
Località San Sisto, 06156 Perugia PG,
Italy.
Background—Increased left
ventricular (LV) mass predicts an adverse outcome in
patients with essential hypertension. The purpose of this study was to
determine the relation between changes in LV mass during
antihypertensive treatment and subsequent prognosis.
Methods and Results—Procedures including
echocardiography and 24-hour ambulatory blood
pressure (BP) monitoring were performed in 430 patients with essential
hypertension before therapy and after 1217 patient-years. Months or
years after the follow-up visit, 31 patients suffered a first
cardiovascular morbid event. The patients with a
decrease in LV mass from the baseline to follow-up visit were compared
with those with an increase in LV mass. There were 15 events (1.78 per
100 person-years) in the group with a decrease in LV mass and 16 events
(3.03 per 100 person-years) in the group with an increase in LV mass
(P=.029). In a Cox model, the lesser
cardiovascular risk in the group with a decrease in LV
mass (hazard ratio [HR], 0.46; 95% CI, 0.22 to 0.99) remained
significant (P=.04) after adjustment for age (HR, 1.06;
95% CI, 1.03 to 1.10; P=.0008) and baseline LVH at ECG
(HR, 3.85; 95% CI, 1.52 to 9.78; P=.012). In that
model, baseline LV mass bordered on statistical significance (HR, 1.01;
95% CI, 1.00 to 1.03; P=.06). In the subset with LV
mass >125 g/m2 at the baseline visit (26%
of subjects), the event rate was lower among the subjects who achieved
regression of LVH than in those who did not (1.58 versus 6.27 events
per 100 person-years; P=.002). This difference held in
the multivariate analysis (HR, 0.18; 95% CI,
0.05 to 0.68).
Conclusions—In essential hypertension, a reduction in LV mass
during treatment is a favorable prognostic marker that predicts a
lesser risk for subsequent cardiovascular morbid
events. Such an association is independent of baseline LV mass,
baseline clinic and ambulatory BP, and degree of BP reduction.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Prognostic Significance of Serial Changes in Left Ventricular Mass in Essential Hypertension
Key Words: hypertension • prognosis • hypertrophy • echocardiography • electrocardiography
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F. Perticone, R. Ceravolo, A. Pujia, G. Ventura, S. Iacopino, A. Scozzafava, A. Ferraro, M. Chello, P. Mastroroberto, P. Verdecchia, et al. Prognostic Significance of Endothelial Dysfunction in Hypertensive Patients Circulation, July 10, 2001; 104(2): 191 - 196. [Abstract] [Full Text] [PDF]
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S. Perlini, M. L. Muiesan, C. Cuspidi, L. Sampieri, B. Trimarco, G. P. Aurigemma, E. Agabiti-Rosei, and G. Mancia Midwall Mechanics Are Improved After Regression of Hypertensive Left Ventricular Hypertrophy and Normalization of Chamber Geometry Circulation, February 6, 2001; 103(5): 678 - 683. [Abstract] [Full Text] [PDF]
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V. Palmieri, J. N. Bella, D. K. Arnett, J. E. Liu, A. Oberman, M.-Y. Schuck, D. W. Kitzman, P. N. Hopkins, D. Morgan, D. C. Rao, et al. Effect of Type 2 Diabetes Mellitus on Left Ventricular Geometry and Systolic Function in Hypertensive Subjects : Hypertension Genetic Epidemiology Network (HyperGEN) Study Circulation, January 2, 2001; 103(1): 102 - 107. [Abstract] [Full Text] [PDF]
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J. H. O'Keefe, M. Wetzel, R. R. Moe, K. Brosnahan, and C. J. Lavie Should an angiotensin-converting enzyme inhibitor be standard therapy for patients with atherosclerotic disease? J. Am. Coll. Cardiol., January 1, 2001; 37(1): 1 - 8. [Abstract] [Full Text] [PDF]
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P. Verdecchia, G. Schillaci, G. Reboldi, F. Santeusanio, C. Porcellati, and P. Brunetti Relation Between Serum Uric Acid and Risk of Cardiovascular Disease in Essential Hypertension : The PIUMA Study Hypertension, December 1, 2000; 36(6): 1072 - 1078. [Abstract] [Full Text] [PDF]
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P.O. Lim and T.M. MacDonald Step test in hypertension QJM, November 1, 2000; 93(11): 703 - 705. [Full Text] [PDF]
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J. Mayet, B. Ariff, B. Wasan, N. Chapman, M. Shahi, N. R. Poulter, P. S. Sever, R. A. Foale, and S. A. McG. Thom Improvement in Midwall Myocardial Shortening With Regression of Left Ventricular Hypertrophy Hypertension, November 1, 2000; 36(5): 755 - 759. [Abstract] [Full Text] [PDF]
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K. Rajappan, N. G. Bellenger, L. Anderson, and D. J. Pennell The role of cardiovascular magnetic resonance in heart failure Eur J Heart Fail, September 1, 2000; 2(3): 241 - 252. [Abstract] [Full Text] [PDF]
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T. Tamura, S. Said, J. Harris, W. Lu, and A. M. Gerdes Reverse Remodeling of Cardiac Myocyte Hypertrophy in Hypertension and Failure by Targeting of the Renin-Angiotensin System Circulation, July 11, 2000; 102(2): 253 - 259. [Abstract] [Full Text] [PDF]
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J. S. Gottdiener, A. M. Arnold, G. P. Aurigemma, J. F. Polak, R. P. Tracy, D. W. Kitzman, J. M. Gardin, J. E. Rutledge, and R. C. Boineau Predictors of congestive heart failure in the elderly: the cardiovascular health study J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1628 - 1637. [Abstract] [Full Text] [PDF]
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R. N. FOLEY, P. S. PARFREY, G. M. KENT, J. D. HARNETT, D. C. MURRAY, and P. E. BARRE Serial Change in Echocardiographic Parameters and Cardiac Failure in End-Stage Renal Disease J. Am. Soc. Nephrol., May 1, 2000; 11(5): 912 - 916. [Abstract] [Full Text]
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P. Verdecchia Prognostic Value of Ambulatory Blood Pressure : Current Evidence and Clinical Implications Hypertension, March 1, 2000; 35(3): 844 - 851. [Abstract] [Full Text] [PDF]
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G. Schillaci, P. Verdecchia, C. Porcellati, O. Cuccurullo, C. Cosco, and F. Perticone Continuous Relation Between Left Ventricular Mass and Cardiovascular Risk in Essential Hypertension Hypertension, February 1, 2000; 35(2): 580 - 586. [Abstract] [Full Text] [PDF]
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G. Parati, L. Ulian, L. Sampieri, P. Palatini, A. Villani, A. Vanasia, and G. Mancia Attenuation of the "White-Coat Effect" by Antihypertensive Treatment and Regression of Target Organ Damage Hypertension, February 1, 2000; 35(2): 614 - 620. [Abstract] [Full Text] [PDF]
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 R. D. Feldman, N. Campbell, P. Larochelle, P. Bolli, E. D. Burgess, S. G. Carruthers, J. S. Floras, R. B. Haynes, G. Honos, F. H.H. Leenen, et al. 1999 Canadian recommendations for the management of hypertension Can. Med. Assoc. J., December 14, 1999; 161(90120): S1 - 17. [Abstract] [Full Text] [PDF]
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V. Palmieri, B. Dahlof, V. DeQuattro, N. Sharpe, J. N. Bella, G. de Simone, M. Paranicas, D. Fishman, and R. B. Devereux Reliability of echocardiographic assessment of left ventricular structure and function: The PRESERVE study J. Am. Coll. Cardiol., November 1, 1999; 34(5): 1625 - 1632. [Abstract] [Full Text] [PDF]
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M. G. Modena, N. Muia Jr, P. Aveta, R. Molinari, and R. Rossi Effects of Transdermal 17{beta}-Estradiol on Left Ventricular Anatomy and Performance in Hypertensive Women Hypertension, November 1, 1999; 34(5): 1041 - 1046. [Abstract] [Full Text] [PDF]
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P. Verdecchia, G. Reboldi, G. Schillaci, C. Borgioni, A. Ciucci, M. P. Telera, F. Santeusanio, C. Porcellati, and P. Brunetti Circulating Insulin and Insulin Growth Factor-1 Are Independent Determinants of Left Ventricular Mass and Geometry in Essential Hypertension Circulation, October 26, 1999; 100(17): 1802 - 1807. [Abstract] [Full Text] [PDF]
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 A. Mosterd, R. B. D'Agostino, H. Silbershatz, P. A. Sytkowski, W. B. Kannel, D. E. Grobbee, and D. Levy Trends in the Prevalence of Hypertension, Antihypertensive Therapy, and Left Ventricular Hypertrophy from 1950 to 1989 N. Engl. J. Med., April 22, 1999; 340(16): 1221 - 1227. [Abstract] [Full Text] [PDF]
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F. Perticone, R. Maio, R. Ceravolo, C. Cosco, C. Cloro, and P. L. Mattioli Relationship Between Left Ventricular Mass and Endothelium-Dependent Vasodilation in Never-Treated Hypertensive Patients Circulation, April 20, 1999; 99(15): 1991 - 1996. [Abstract] [Full Text] [PDF]
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H. Schirmer, P. Lunde, and K. Rasmussen Prevalence of left ventricular hypertrophy in a general population; The Tromso Study Eur. Heart J., March 2, 1999; 20(6): 429 - 438. [Abstract] [PDF]
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P. Verdecchia, G. Schillaci, C. Borgioni, A. Ciucci, S. Pede, and C. Porcellati Ambulatory Pulse Pressure : A Potent Predictor of Total Cardiovascular Risk in Hypertension Hypertension, December 1, 1998; 32(6): 983 - 988. [Abstract] [Full Text] [PDF]
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A. W. Haider, M. G. Larson, E. J. Benjamin, and D. Levy Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death J. Am. Coll. Cardiol., November 1, 1998; 32(5): 1454 - 1459. [Abstract] [Full Text] [PDF]
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