Intensive Blood Pressure Lowering and Regression of Left Ventricular Hypertrophy
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- coronary artery disease
- hypertrophy, left ventricular
- myocardial infarction
Article, see p 440
The SPRINT trial (Systolic Blood Pressure Intervention) (ClinicalTrials.gov. Unique identifier: NCT01206062), is a landmark study that randomly assigned 9361 treated or untreated hypertensive patients with a systolic blood pressure (SBP) of 130 to 180 mm Hg at entry and high cardiovascular risk to a SBP goal of <140 mm Hg (standard treatment group) or <120 mm Hg (intensive treatment group).1 The hypothesis of superiority of the more intensive over the less intensive strategy was demonstrated through a significant 25% reduction in the primary composite cardiovascular end point.1 Beyond modifying our approach to the management of hypertensive patients,2 the SPRINT study offers a unique opportunity to test the clinical value of several intermediate outcome measures beyond SBP reduction in hypertensive patients.
In the current issue of Circulation, Soliman et al3 present a post hoc analysis of the SPRINT trial. The analysis compared the 2 randomized groups with respect to the serial changes of left ventricular hypertrophy (LVH) diagnosed by standard ECG taken at baseline and every 2 years during follow-up. LVH was defined categorically by a Cornell voltage (RaVL+SV3 amplitude) >2200 μV in women and >2800 μV in men4 and also by using other ECG criteria including the Cornell voltage as a continuous variable, the Cornell product …