Electrocardiographic Left Ventricular Mass Trajectories and the Effects of Treatment in Patients at Different Stages of Hypertension
<b>Background:</b> The comparison of left ventricular mass (LVM) at different BP levels and the effects of antihypertensive drug treatment on LVM are unknown. <b>Objective:</b> To compare the LVM of individuals with prehypertension and Stage 1 hypertension and assess the effects of treatment on LVM at these stages of hypertension. <b>Methods:</b> We estimated LVM in the PREVER-Prevention trial using Sokolow-Lyon and Cornell voltage and voltage-duration products before and after randomization to 18 months of treatment with low doses of chlorthalidone and amiloride or placebo in adults with JNC 7 "prehypertension" (systolic BP [SBP] of 120-139 mm Hg and diastolic BP [DBP] of 80-89 mm Hg). Similarly, in the PREVER-Treatment trial, we assessed these indices before and after randomization to 18 months of treatment with the chlorthalidone/amiloride combination or losartan in adults with JNC 7 "stage 1" hypertension (140-159 mm Hg or DBP of 90-99 mm Hg). <b>Results:</b> At baseline, the participants in the stage I hypertension trial exhibited higher mean LVM indices than those in the prehypertension trial. In the PREVER-Prevention trial, those randomized to the chlorthalidone/amiloride combination experienced a significant reduction in Sokolow-Lyon LVM indices compared to placebo (<i>p</i> = 0.02). In the PREVER-Treatment trial, those randomized to the chlorthalidone/amiloride combination or losartan experienced a similar reduction in electrocardiographic LVM during the 18 months of treatment (<i>p</i> < 0.01). <b>Conclusions:</b> The institution of low-dose antihypertensive drug therapy in prehypertension and treatment of patients with stage 1 hypertension has the potential to interrupt the progress of hypertensive cardiomyopathy.
Authors
- Paulo César Brandão Veiga Jardim (ORCID: https://orcid.org/0000-0002-5333-013X)
- Luiz Aparecido Bortolotto (ORCID: https://orcid.org/0000-0002-4865-6442)
- Rosane Paixão Schlatter
- Andréa Araújo Brandão (ORCID: https://orcid.org/0000-0002-7040-396X)
- Flávio Danni Fuchs (ORCID: https://orcid.org/0000-0002-1191-0523)
- Marcos Roberto de-Sousa
- Otávio Berwanger (ORCID: https://orcid.org/0000-0002-4972-2958)
- André Avelino Steffens
- João Guilherme Bezerra Alves (ORCID: https://orcid.org/0000-0002-9170-0808)
- Leila Beltrami Moreira (ORCID: https://orcid.org/0000-0002-4730-7988)
- Ana Tavares (ORCID: https://orcid.org/0000-0002-4393-8387)
- Ricardo Pereira e Silva
- Fernando Nobre (ORCID: https://orcid.org/0000-0003-2311-4222)
- Paul K. Whelton (ORCID: https://orcid.org/0000-0002-2225-383X)
- José Albuquerque de Figueiredo Neto (ORCID: https://orcid.org/0000-0003-3739-7702)
- Carlos Eduardo Poli‐de‐Figueiredo (ORCID: https://orcid.org/0000-0002-7333-8884)
- Felipe Costa Fuchs (ORCID: https://orcid.org/0000-0001-5018-9989)
- Sandra Cristina Pereira Costa Fuchs (ORCID: https://orcid.org/0000-0001-6351-9588)
- Evandro José Cesarino (ORCID: https://orcid.org/0000-0003-1672-4612)
- José Fernando Vilela-Martin (ORCID: https://orcid.org/0000-0001-6960-2825)
- Luíz Cesar Nazário Scala
- Dário Celestino Sobral Filho (ORCID: https://orcid.org/0000-0002-5301-7741)
- Antônio Cláudio Lucas da Nóbrega (ORCID: https://orcid.org/0000-0002-3830-2886)
- Iran Castro
- Roberto Silva Franco
- Miguel Gus
- Marco M. Gomes
- Leonardo Krause Valter
- Beatriz Padoin Camilo
Institutions
- Tulane University (US)
- Universidade de Ribeirão Preto (BR)
- Faculdade de Medicina de São José do Rio Preto (BR)
- Universidade Federal de Pelotas (BR)
- Universidade Federal do Ceará (BR)
- Universidade Federal de Mato Grosso (BR)
- Universidade do Estado do Rio de Janeiro (BR)
- Hospital de Clínicas de Porto Alegre (BR)
- Hospital Universitário Walter Cantídio (BR)
- Instituto de Medicina Integral Professor Fernando Figueira (BR)
- Fundação Universitária de Cardiologia (BR)
- Medecell (Brazil) (BR)
- Hospital Universitário da Universidade Federal do Maranhão (BR)
- Hospital das Clínicas da Universidade Federal de Minas Gerais (BR)
- Hospital Universitário Antônio Pedro (BR)
- Hospital São Lucas da PUCRS (BR)
- Hospital do Coração (BR)
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR)
- JP Group (Brazil) (BR)
- Imperial College London (GB)
- Universidade Federal de Goiás (BR)
Publication Details
- Journal
- Journal of Clinical Medicine
- Published
- 2025-03-28
- DOI
- https://doi.org/10.3390/jcm14072313
- Primary Topic
- Blood Pressure and Hypertension Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior