Abstract 14850: Determinants of Left Ventricular Mass Regression in a Hypertensive Population: a Follow-up Study
Introduction: Left ventricular hypertrophy is a reversible risk factor and its regression improves cardiovascular (CV) prognosis.
Hypothesis: To investigate the determinants of left ventricular mass (LVM) regression in treated hypertensive patients over a mean period of 3.45±1.33 years.
Methods: We investigated 301 patients without diabetes and CV disease (51±10 years, 189 men, 123 smokers, waist circumference [WC] 97±12cm). 24h blood pressure (BP) monitoring, metabolic profile, creatinine clearance (GFR) evaluation and echocardiographic measurements were done at baseline and last visit. Optimal antihypertensive therapy, lifestyle interventions and vasoactive drugs (i.e. statins, antiplatelet therapy) were implemented. The prescribed drugs were entered in the analyses either as a categorical variable (i.e. yes or no during the last 6 months of follow up) or as the duration of their implementation in the whole follow-up period. LVM was estimated per its 2.7 allometric power, as participants were overweight (baseline body mass index=28.5±4.7Kgr/m²). 10% reduction of baseline LVM/height (g/m2.7) was defined as LVM regression.
Results: Between baseline and last visit a decrease in: 24h systolic and diastolic BP by 13±10 and 9±6mmHg, respectively, 24h heart rate by 6±6bpm, WC by 5±5cm and LVM/height by 8±7(g/m2.7) was detected. 162 patients (53.8%) presented regression of LVM/height at end-follow-up (49±10 vs. 46±9 g/m2.7). In Cox-regression analysis using demographic, metabolic and treatment variables LVM regression was finally predicted by: baseline LVM/height (OR=1.035, 95%OR C.I.= 1.020-1.049, p<0.001), ACEi usage (OR=7.082, 95%OR C.I.= 3.57-14.1, p<0.001), duration of ACEi usage (OR=1.34, 95%OR C.I. =1.12-2.32, p<0.001) and diuretic usage (OR=4.45, 95%OR C.I.=2.1-9.89, p<0.001).
Conclusions: ACEi and diuretics favour LVM regression in overweight hypertensive subjects, beyond the lowering of BP, especially when the initial levels of LVM are higher. The duration of treatment with ACEi constituted a further determinant of LVM regression.
- © 2011 by American Heart Association, Inc.