Regression of left ventricular hypertrophy in patients with essential hypertension - Results of 6 month treatment with indapamide

被引:13
作者
Curry, CL [1 ]
Robinson, H [1 ]
Brown, R [1 ]
Olivan, J [1 ]
Sami, M [1 ]
Honos, G [1 ]
Ruddy, TD [1 ]
Balazovjech, I [1 ]
Touzek, F [1 ]
Galinier, F [1 ]
Mariani, M [1 ]
deCordoue, A [1 ]
Barrandon, S [1 ]
Brault, Y [1 ]
Guez, D [1 ]
机构
[1] HOWARD UNIV HOSP,WASHINGTON,DC
关键词
diuretics; hypertension; left ventricular hypertrophy; indapamide; blood pressure;
D O I
10.1016/0895-7061(96)00105-7
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Left ventricular hypertrophy (LVH) is a major risk factor for cardiovascular morbidity in hypertensive patients. The effects of diuretics on LVH have raised controversies, but recent studies suggest that diuretics are able to reduce LVH in hypertensive patients, mainly through a reduction in ventricular diameter. The present multicenter open study was designed to test the effects of indapamide, a widely used nonthiazide diuretic, on LVH in patients with essential hypertension. Patients had to have mild-to-moderate essential hypertension (supine diastolic blood pressure [sDBP] 95 to 115 mm Hg) with echocardiographic evidence of LVH (left ventricular mass index [LVMI] > 130 g/m(2) for men and > 110 g/m(2) for women). After a 2 week placebo run-in period, eligible patients underwent a 6 month treatment with 2.5 mg indapamide daily. All echograms were performed by the same investigator before and after 6 months of indapamide. Clinical and biological acceptability and quality of life (visual analog scale) were also studied. One hundred and thirty patients were included in the study and 112 completed the trial. Indapamide induced a significant reduction in systolic and diastolic blood pressures. Indapamide induced a marked reduction in posterior wall thickness (from 12.1 +/- 2.0 to 11.2 +/- 1.6 mm) and in interventricular wall thickness (from 12.7 +/- 1.7 to 11.8 +/- 1.9 mm; each P < .001) and a slight decrease in left ventricular diameter (P = .049). This resulted in a 13% reduction in LVMI (from 161.9 +/- 37.9 to 140.7 +/- 33.8 g/m(2), P < .001). Left ventricular fractional shortening remained unchanged. There was no significant relation between changes in LVMI and changes in systolic, diastolic, or mean blood pressure. No significant adverse clinical or biological effects were reported during the study. The increased score of the visual analog scale indicated that overall well-being was improved (P < .001). Our study indicates that indapamide, in addition to blood pressure control, is able to reduce LVH. This effect was achieved mainly through a reduction in wall thicknesses rather than in internal cavity diameter.
引用
收藏
页码:828 / 832
页数:5
相关论文
共 15 条
[1]   CLINICAL EFFICACY AND QUALITY OF LIFE WITH INDAPAMIDE ALONE OR IN COMBINATION WITH BETA-BLOCKERS OR ANGIOTENSIN-CONVERTING ENZYME-INHIBITORS [J].
ATHANASSIADIS, DI ;
DIMOPOULOS, CG ;
TSAKIRIS, AK ;
COKKINOS, DF ;
TOURKANTONIS, AA ;
TOUTOUZAS, PK ;
BOUTIN, B ;
GUEZ, D .
AMERICAN JOURNAL OF CARDIOLOGY, 1990, 65 (17) :H62-H66
[2]  
CARETTA R, 1983, EUR J CLIN PHARMACOL, V24, P579
[3]  
CHAFFMAN M, 1988, DRUGS, V28, P189
[4]  
CHERCHI A, 1987, J CLIN HYPERTENS, V3, P218
[5]   REVERSAL OF LEFT-VENTRICULAR HYPERTROPHY IN HYPERTENSIVE PATIENTS - A METAANALYSIS OF 109 TREATMENT STUDIES [J].
DAHLOF, B ;
PENNERT, K ;
HANSSON, L .
AMERICAN JOURNAL OF HYPERTENSION, 1992, 5 (02) :95-110
[6]   METHODS FOR DETECTION OF LEFT-VENTRICULAR HYPERTROPHY - APPLICATION TO HYPERTENSIVE HEART-DISEASE [J].
DEVEREUX, RB ;
KOREN, MJ ;
DESIMONE, G ;
OKIN, PM ;
KLIGFIELD, P .
EUROPEAN HEART JOURNAL, 1993, 14 :8-15
[7]  
GOTTDIENER J, 1992, J AM COLL CARDIOL S, V19, P85
[8]  
GRIMM M, 1981, BRIT HEART J, V46, P404
[9]  
Guez D, 1988, Am J Med, V84, P53
[10]   EFFECTS OF INDAPAMIDE ON LEFT-VENTRICULAR MASS AND FUNCTION IN SYSTEMIC HYPERTENSION WITH LEFT-VENTRICULAR HYPERTROPHY [J].
KOMAJDA, M ;
KLIMCZAK, K ;
BOUTIN, B ;
BRACKMAN, F ;
GUEZ, D ;
GROSGOGEAT, Y .
AMERICAN JOURNAL OF CARDIOLOGY, 1990, 65 (17) :H37-H42