The influence of different antihypertensive drugs on left ventricular hypertrophy in a population sample of elderly men

Abstract

Aims and methods: To evaluate if the effects of long-term treatment with different antihypertensive drugs on left ventricular (LV) hypertrophy seen in meta-analysis could also be found in a cross-sectional study of elderly men, we investigated 584 70-year-old men with echocardiography of which 179 were treated for hypertension. Results: Men on antihypertensive treatment showed a significantly higher LV mass than normotensive men (143 ± 29 vs 132 ± 28 g/m², P < 0.01), but no significant difference in lv mass was seen between men on one antihypertensive drug (n = 129) and those on two drugs (n = 47). Among the men on monotherapy, no differences in LV mass between the subjects who were treated with calcium-antagonists (142 ± 27 g/m², n = 37), beta-blockers (140 ± 29 g/m², n = 66) or ACE-inhibitors (142 ± 33 g/m², n = 20) were found. Neither did blood pressure differ between these groups. Excluding subjects with coronary heart disease did not alter the results. Thiazides as monotherapy was uncommon in this population (n = 4) and therefore not evaluated. Conclusion: In a population sample of elderly men with hypertension, no differences in LV mass or blood pressure could be seen between subjects treated with ACE-inhibitors, calcium-antagonists or beta-blockers as monotherapy. In meta-analysis of the effects of different antihypertensive therapies on regression of LV hypertrophy, ACE-inhibitors have shown the best results.