Successful treatment of hypertension accounts for improvements in markers of diastolic function − a pilot study comparing hydrochlorothiazide-based and amlodipine-based treatment strategies

Background There is controversy regarding whether blood pressure (BP) medications have relevant therapeutic benefits beyond those due to lowering of BP. Objective To show that rapid successful treatment of hypertension leads to improvement in cardiac morphology and function regardless of the pharmac...

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Bibliographic Details
Published in:Canadian journal of cardiology 2009-12, Vol.25 (12), p.e406-e412
Main Authors: Ogunyankin, Kofo O., MD, Day, Andrew G., MSc
Format: Article
Language:English
Subjects:
Ambulatory blood pressure monitoring
Amlodipine - therapeutic use
Antihypertensive Agents - therapeutic use
Blood Pressure
Cardiovascular
Clinical Studies
Diastolic function
Drug Therapy, Combination
Female
Humans
Hydrochlorothiazide - therapeutic use
Hypertension - drug therapy
Hypertension - physiopathology
Left ventricular hypertrophy
Male
Middle Aged
Pilot Projects
Tissue Doppler imaging
Treatment Outcome
Ultrasonography
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - drug therapy
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Summary:Background There is controversy regarding whether blood pressure (BP) medications have relevant therapeutic benefits beyond those due to lowering of BP. Objective To show that rapid successful treatment of hypertension leads to improvement in cardiac morphology and function regardless of the pharmacological agents used. Methods Hypertension was defined as an average 24 h ambulatory BP of higher than 135/85 mmHg in 38 subjects with a mean (± SD) age of 54 ± 7 years. Patients were randomly assigned to treatment with a diureticbased (n = 20) or a calcium channel blocker (CCB)-based (n = 18) medication. All subjects were followed every two weeks, and similar additional medications were added until the BP was lower than 125/80 mmHg, then followed monthly for a total of six months. Echocardiography with tissue Doppler imaging was performed, and was repeated after six months of aggressive pharmacotherapy and lifestyle management. Results Baseline ambulatory BP monitoring and echocardiographic measures of diastolic function were similar between both treatment groups. Subjects received 3.5 ± 1 pills and 11 ± 2 follow-up visits. The average 24 h BP was reduced from 145/91 mmHg to 124/75 mmHg (P
ISSN:0828-282X
1916-7075
DOI:10.1016/S0828-282X(09)70534-3