Lack of reduction of left ventricular mass in treated hypertension: the strong heart study.

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Citation: Journal of the American Heart Association. 2(3):e000144, 2013 Jun.PMID: 23744404Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., ExtramuralSubject headings: *Antihypertensive Agents/tu [Therapeutic Use] | *Hypertension/co [Complications] | *Hypertension/dt [Drug Therapy] | *Hypertrophy, Left Ventricular/et [Etiology] | *Hypertrophy, Left Ventricular/pc [Prevention & Control] | Aged | Female | Follow-Up Studies | Humans | Longitudinal Studies | Male | Middle AgedISSN:
  • 2047-9980
Name of journal: Journal of the American Heart AssociationAbstract: BACKGROUND: Hypertensive left ventricular mass (LVM) is expected to decrease during antihypertensive therapy, based on results of clinical trials.CONCLUSIONS: In a free-living population, higher BMI is associated with less reduction of hypertensive LVH; lack of reduction of LVM is independent of BP control and of types of antihypertensive treatment, but is associated with renal damage.METHODS AND RESULTS: We assessed 4-year 130224 of echocardiographic LVM in 851 hypertensive free-living participants of the Strong Heart Study (57% women, 81% treated). Variations of 5% or more of the initial systolic blood pressure (SBP) and LVM were categorized for analysis. At baseline, 23% of men and 36% of women exhibited LV hypertrophy (LVH, P<0.0001). At the follow-up, 3% of men and 10% of women had regression of LVH (P<0.0001 between genders); 14% of men and 15% of women, free of baseline LVH, developed LVH. There was an increase in LVM over time, more in men than in women (P<0.001). Participants whose LVM did not decrease had similar baseline SBP and diastolic BP, but higher body mass index (BMI), waist/hip ratio, heart rate (all P<0.008), and urinary albumin/creatinine excretion (P<0.001) than those whose LVM decreased. After adjusting for field center, initial LVM index, target BP, and kinship degree, lack of decrease in LVM was predicted by higher baseline BMI and urinary albumin/creatinine excretion, independently of classes of antihypertensive medications, and significant effects of older age, male gender, and percentage increase in BP over time. Similar findings were obtained in the subpopulation (n=526) with normal BP at follow-up.All authors: de Simone G, Devereux RB, Girfoglio D, Howard BV, Izzo R, Lee ET, Roman MJDigital Object Identifier: Date added to catalog: 2014-02-24
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Journal Article MedStar Authors Catalog Article Available 23744404

BACKGROUND: Hypertensive left ventricular mass (LVM) is expected to decrease during antihypertensive therapy, based on results of clinical trials.

CONCLUSIONS: In a free-living population, higher BMI is associated with less reduction of hypertensive LVH; lack of reduction of LVM is independent of BP control and of types of antihypertensive treatment, but is associated with renal damage.

METHODS AND RESULTS: We assessed 4-year 130224 of echocardiographic LVM in 851 hypertensive free-living participants of the Strong Heart Study (57% women, 81% treated). Variations of 5% or more of the initial systolic blood pressure (SBP) and LVM were categorized for analysis. At baseline, 23% of men and 36% of women exhibited LV hypertrophy (LVH, P<0.0001). At the follow-up, 3% of men and 10% of women had regression of LVH (P<0.0001 between genders); 14% of men and 15% of women, free of baseline LVH, developed LVH. There was an increase in LVM over time, more in men than in women (P<0.001). Participants whose LVM did not decrease had similar baseline SBP and diastolic BP, but higher body mass index (BMI), waist/hip ratio, heart rate (all P<0.008), and urinary albumin/creatinine excretion (P<0.001) than those whose LVM decreased. After adjusting for field center, initial LVM index, target BP, and kinship degree, lack of decrease in LVM was predicted by higher baseline BMI and urinary albumin/creatinine excretion, independently of classes of antihypertensive medications, and significant effects of older age, male gender, and percentage increase in BP over time. Similar findings were obtained in the subpopulation (n=526) with normal BP at follow-up.

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