Document Detail


Effect of irbesartan versus atenolol on left ventricular mass and voltage: results of the CardioVascular Irbesartan Project.
MedLine Citation:
PMID:  15184349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Regression of hypertensive left ventricular hypertrophy (LVH) is associated with improved prognosis. The aim of this trial was to compare the effects of irbesartan versus atenolol on LVH in subjects with essential hypertension. Because electrocardiographic and echocardiographic parameters of LVH carry disparate prognostic information, both methods were applied in this trial. In the randomized, double-blind, multicenter trial CardioVascular Irbesartan Project, 240 patients with essential hypertension were treated with irbesartan or atenolol for 18 months. Voltage criteria used for LVH were Sokolow index, Cornell index, Cornell voltage x QRS duration product and Lewis index. In parallel, left ventricular mass (LVM) was determined by 2-dimensional guided M-mode echocardiography. After 6 and 18 months, reductions of LVM and voltage criteria for LVH were only found in subjects treated with irbesartan. However, a reduction of LVM was only detectable in subjects within the highest quartile of baseline LVM but not overall. In contrast, reductions of voltage criteria for LVH were detectable after 6 and 18 months even within commonly used normal limits. In conclusion, treatment of hypertension with irbesartan resulted in a significant reduction in the voltage criteria for LVH, although an effect on LVM was only seen in subjects with high baseline LVM. In contrast, atenolol did not lead to reductions in electrocardiographic or echocardiographic parameters of LVH. Because voltage criteria for LVH have been shown to predict cardiovascular outcome independently from LVM, we suggest that both methods should be used to accurately assess the benefits of antihypertensive treatment.
Authors:
Markus P Schneider; Arnfried U Klingbeil; Christian Delles; Malte Ludwig; Rainer E Kolloch; Michael Krekler; Klaus O Stumpe; Roland E Schmieder
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2004-06-07
Journal Detail:
Title:  Hypertension     Volume:  44     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-25     Completed Date:  2004-09-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  61-6     Citation Subset:  IM    
Affiliation:
Department of Medicine IV/Nephrology,University of Erlangen-Nürnberg, Germany. roland.schmieder@rzmail.uni-erlangen.de
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Angiotensin II Type 1 Receptor Blockers
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Antihypertensive Agents / therapeutic use*
Atenolol / therapeutic use*
Biphenyl Compounds / therapeutic use*
Double-Blind Method
Echocardiography
Electrocardiography
Female
Heart Ventricles / physiopathology
Humans
Hypertension / drug therapy*,  physiopathology
Hypertrophy, Left Ventricular / diagnosis*
Male
Middle Aged
Tetrazoles / therapeutic use*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Biphenyl Compounds; 0/Tetrazoles; 138402-11-6/irbesartan; 29122-68-7/Atenolol
Comments/Corrections
Comment In:
Hypertension. 2005 Feb;45(2):e6; author reply e6   [PMID:  15583072 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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