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Diastolic blood pressure reduction contributes more to the regression of left ventricular hypertrophy: a meta-analysis of randomized controlled trials

Journal of Human Hypertension volume 27, pages 698–706 (2013)Cite this article

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Abstract

Left ventricular hypertrophy (LVH) is an independent cardiovascular risk factor; however, the key strategy necessary for LVH regression in hypertensive patients is not clear. A meta-analysis was conducted to study the effect of blood pressure reduction on LVH regression. We explored the relationship between different degrees of systolic blood pressure (SBP)/diastolic blood pressure (DBP) reduction and LVH regression. A total of 17 randomized controlled trials comprising 2196 hypertensive patients (mean age, 56.3 years; 64.1% were men) were identified. Different degrees of SBP and DBP reductions were significantly associated with LVH regression: SBP reduction ⩾20 mm Hg (SBPM20) (weighted mean difference (WMD): 14.35 g m−2; 95% confidence interval (CI): 10.44, 18.26; P<0.0001); SBP reduction <20 mm Hg (SBPL20 group) (WMD: 14.82 g m−2; 95% CI: 9.83, 19.82; P<0.0001); DBP reduction ⩾10 mm Hg (DBPM10 group) (WMD: 15.17 g m−2; 95% CI: 11.86, 18.48; P<0.0001); and DBP reduction <10 mm Hg (DBPL10 group) (WMD: 11.76 g m−2; 95% CI: 3.75, 19.76; P=0.004). Significant regression of LVH was found in the DBPM10 group compared with the SBPM20, SBPL20 and DBPL10 groups (P<0.0001). The most significant decrease in LVH was seen in patients with a mean age over 60 years in the DBPM10 group. Moreover, the renin–angiotensin system inhibitor was found to be the most effective antihypertensive drug for LVH regression. This meta-analysis result indicates that proper DBP reduction plays an important role in the regression of echocardiographic LVH in hypertensive patients.

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Acknowledgements

This work was supported in part by NSFC [81170647, 91029742, 30973207 and 11101439], Fok Ying-Tong Education Foundation for Young Teachers in the Higher Education Institutions of China [132030], Yat-sen Scholarship for Young Scientists and the Science & technology star of Zhujiang (Guangzhou) to Hui Huang.

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Authors and Affiliations

  1. Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China

    K Zhang, J Wang & H Huang

  2. Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China

    K Zhang, J Chen, T Wang, L Wang, J Wang & H Huang

  3. Department of Radiation Oncology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China

    J Chen & Y Liu

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Correspondence to H Huang.

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Zhang, K., Chen, J., Liu, Y. et al. Diastolic blood pressure reduction contributes more to the regression of left ventricular hypertrophy: a meta-analysis of randomized controlled trials. J Hum Hypertens 27, 698–706 (2013). https://doi.org/10.1038/jhh.2013.20

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