Document Detail

Importance of blood pressure control in left ventricular mass regression.
MedLine Citation:
PMID:  20980215     Owner:  NLM     Status:  MEDLINE    
Blood pressure (BP) reduction to 140/90 mm Hg or lower using renin-angiotensin-system blockers reportedly provides the greatest left ventricular (LV) mass regression; β-blockers have less effect. This study examined whether combination antihypertensive therapy would provide greater benefit. With a double-blind, parallel-group design, the effects of 3 different combinations, carvedilol controlled-release (CR)/lisinopril, atenolol/lisinopril, and lisinopril, on left ventricular mass index (LVMI) were assessed by MRI after 12 months. Patients were treated to achieve guideline-recommended BP (<140 mm Hg/<90 mm Hg; diabetes: <130 mm Hg/<80 mm Hg). Sample size was calculated to achieve 90% power to detect a 5 g/m(2) difference in mean change from baseline in LVMI between the carvedilol CR/lisinopril group and each of the other treatment groups. Of 287 patients randomized, more than 50% were titrated to maximum dosage; 73% reached targeted BP. At month 12 (last observation carried forward ≥ month 9) for 195 evaluable subjects, mean BP was similar in all groups (carvedilol CR/lisinopril: 128.8/77.9; atenolol/lisinopril: 128.7/76.5; lisinopril: 126.3/80.3 mm Hg). Compared with baseline, mean LVMI decreased to a similar extent in all groups (carvedilol CR/lisinopril: -6.3; atenolol/lisinopril: -6.7; lisinopril: -7.9 g/m(2)). Achievement of targeted BP control is more important than treatment regimen in achieving LV mass reduction.
Alan B Miller; Nathaniel Reichek; Martin St John Sutton; Malini Iyengar; Linda S Henderson; Elizabeth A Tarka; George L Bakris
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-10-27
Journal Detail:
Title:  Journal of the American Society of Hypertension : JASH     Volume:  4     ISSN:  1933-1711     ISO Abbreviation:  J Am Soc Hypertens     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-12-06     Completed Date:  2011-02-16     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101312518     Medline TA:  J Am Soc Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  302-10     Citation Subset:  IM    
Copyright Information:
2010 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
Division of Cardiology, Department of Medicine, University of Florida, Jacksonville, Florida 32209, USA.
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MeSH Terms
Antihypertensive Agents / therapeutic use*
Atenolol / therapeutic use
Carbazoles / therapeutic use
Creatinine / urine
Delayed-Action Preparations
Double-Blind Method
Drug Therapy, Combination
Echocardiography, Doppler
Heart Ventricles / pathology
Hypertension / drug therapy*
Hypertrophy, Left Ventricular / drug therapy*,  pathology*
Lisinopril / therapeutic use
Magnetic Resonance Imaging, Cine
Middle Aged
Propanolamines / therapeutic use
United States
Reg. No./Substance:
0/Antihypertensive Agents; 0/Carbazoles; 0/Delayed-Action Preparations; 0/Propanolamines; 0K47UL67F2/carvedilol; 29122-68-7/Atenolol; 60-27-5/Creatinine; 83915-83-7/Lisinopril

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