Two new studies found that lowering left ventricular hypertrophy (LVH) with hypertension medications can further reduce the risk of heart problems in patients whose blood pressure has been significantly lowered. The results of the studies, reported in the Journal of the American Medical Association (November 17, 2004), are based on research from 9193 men and women with high blood pressure. The participants were being treated with either losartan or the beta-blocker atenolol.
In one study, the researchers evaluated rates of heart attacks, strokes, and related deaths over 5 years. Using electrocardiograms, LVH was measured annually. The findings showed that patients whose tests indicated significant LVH reduction were 29% less likely to have cardiovascular-related deaths and nonfatal heart attacks and strokes, compared with those patients whose LVH was unchanged. In the second study involving a subset of patients tested with echocardiograms, the researchers found similar results.
Because hypertension is the most common cause of LVH, Peter Okin, MD, lead author of one study, recommended that all patients with high blood pressure should be tested for LVH periodically throughout treatment. Patients whose LVH is not getting better or getting worse should be treated more aggressively, Dr. Okin added. The American Heart Association disagreed, claiming that routine tests to examine LVH in patients are too costly and premature. A spokesman for the association, Daniel Jones, MD, said the results of the 2 studies were small, and lowering patients'blood pressure should remain a top priority.
One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
Clinical features with downloadable PDFs