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Sex-related difference in regression of left ventricular hypertrophy with antihypertensive treatment: the LIFE study

Journal of Human Hypertension volume 18, pages 411–416 (2004)Cite this article

Abstract

While left ventricular (LV) structure and function differ between hypertensive women and men, it remains unclear whether sex affects regression of LV hypertrophy with antihypertensive treatment. We analysed paired echocardiograms in 500 men and 347 women enrolled in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study at baseline and after 12 months of antihypertensive treatment with either losartan or atenolol. At enrolment, 177 women and 242 men were randomized to losartan-based treatment and 161 women and 247 men were randomized to atenolol-based treatment (sex difference=NS). After 12 months of antihypertensive treatment, blood pressure was lowered similarly in women (152/83 from 174/97 mmHg) and men (149/85 from 173/99 mmHg; both P<0.001, sex difference=NS), without significant change in body weight in either sex. Cardiac output and pulse pressure/stroke volume were equivalently reduced in both sexes (−0.2 vs −0.1 l/min and both –0.20 mmHg/ml/m2, respectively; both P=NS). Absolute LV mass change after 12 months of antihypertensive treatment was greater in men than in women (−30 vs −24 g, P=0.01). However, after adjusting for baseline LV mass and randomized study treatment, LV mass reduction was greater in women than in men (−33 vs −23 g, P=0.001). LV mass regression was greater in women, by 8.0±2.8 g, after adjusting for baseline LV mass and randomized study treatment. After consideration of baseline LV mass and randomized study treatment, antihypertensive treatment regressed LV hypertrophy more in women. Further studies are needed to identify the mechanisms and prognostic implications of this sex-related difference.

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Acknowledgements

We thank Mary Paranicas, BA, Anne Morosky, BA, and Andreas Moan, MD, for their invaluable assistance with study coordination and Dawn Fishman, BA, for assistance in data management. We thank Paulette A. Lyle, BS, for assistance with the manuscript. Furthermore, we would like to thank the LIFE echocardiography study investigators.

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Authors and Affiliations

  1. Weill Medical College of Cornell University, New York, NY, USA

    J N Bella, V Palmieri, J E Liu & R B Devereux

  2. Copenhagen County University Hospital, Glostrup, Denmark

    K Wachtell

  3. Haukeland Hospital, Bergen, Norway

    E Gerdts

  4. Helsinki Central University Hospital, Helsinki, Finland

    M S Nieminen

  5. Jacksonville Cardiovascular Clinic, Jacksonville, FL, USA

    M J Koren

  6. University of Texas Health Science Center, San Antonio, TX, USA

    M Zabalgoitia

  7. University Hospitals of Cleveland, Cleveland, OH, USA

    J T Wright

  8. Sahlgrenska University Hospital/Östra, Göteborg, Sweden

    B Dahlöf

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  1. J N Bella
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  2. V Palmieri
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  3. K Wachtell
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  4. J E Liu
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  5. E Gerdts
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  6. M S Nieminen
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  7. M J Koren
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  10. B Dahlöf
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  11. R B Devereux
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Correspondence to J N Bella.

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Supported by Grant COZ-368 from Merck & Co., Inc., West Point, PA, USA.

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Bella, J., Palmieri, V., Wachtell, K. et al. Sex-related difference in regression of left ventricular hypertrophy with antihypertensive treatment: the LIFE study. J Hum Hypertens 18, 411–416 (2004). https://doi.org/10.1038/sj.jhh.1001708

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