Impact of isolated systolic hypertension on normalization of left ventricular structure during antihypertensive treatment (the LIFE study). (August 2014)

• Record Type: Journal Article
• Authors: Mancusi, Costantino; Gerdts, Eva; De Simone, Giovanni; Abdelhai, Yassein M.; Lønnebakken, Mai Tone; Boman, Kurt; Wachtell, Kristian; Dahlöf, Björn; Devereux, Richard B.
• Is Part Of: Blood pressure. Volume 23:Number 4(2014)
• Page Start: 206
• Page End: 212
• Publication Date: 2014-08
• Subjects: Blood pressure -- Periodicals; Hypertension -- Periodicals; Hypertension -- Periodicals; Blood Pressure -- Periodicals; 612.14
• DOI: 10.3109/08037051.2013.858482
• Languages: English
• ISSNs: 0803-7051

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective.</italic> We tested the impact of isolated systolic hypertension (ISH) on normalization of left ventricular (LV) structure during antihypertensive treatment. <italic>Methods.</italic> Baseline and annual echocardiograms were recorded in 873 hypertensive patients with electrocardiographic signs of LV hypertrophy during 4.8 years randomized losartan- or atenolol-based antihypertensive treatment in the Losartan Intervention For Endpoint (LIFE) reduction in hypertension study and classified as having ISH (<italic>n = </italic>128) if systolic BP ≥ 160 mmHg and diastolic BP < 90 mmHg, or non-ISH divided into two groups by systolic BP ≥ 160 mmHg (non-ISH ≥ 160 mmHg) (<italic>n = </italic>645) and systolic BP < 160 mm Hg (<italic>n = </italic>100) (non-ISH < 160 mmHg), respectively. <italic>Results.</italic> Patients with ISH were older, with higher prevalence of diabetes than non-ISH groups and higher pulse pressure/stroke volume index (all <italic>p < </italic>0.05). Baseline systolic blood pressure (BP) differed between groups and was highest in the non-ISH ≥ 160 mmHg group (<italic>p < </italic>0.05). Systolic BP reduction was less in the ISH group (<italic>p < </italic>0.05). LV geometry did not differ between ISH and non-ISH ≥ 160 mmHg groups at baseline, but ISH had more residual LV hypertrophy of concentric type at the last study visit (<italic>p < </italic>0.05). In multivariate analysis, less reduction of LV mass was predicted by ISH (β = − 0.07) independent of significant associations with baseline LVMi (β = 0.52) and atenolol-based treatment (β = − 0.08) and clinical confounders (all <italic>p < </italic>0.05). <italic>Conclusions.</italic> ISH is associated with impaired normalization of LV mass during systematic antihypertensive treatment. The findings may help explain the higher cardiovascular event rate previously reported in ISH patients.</p> </abstract>