This Article Full Text Full Text (PDF) Data Supplement All Versions of this Article: 54/4/731    most recent HYPERTENSIONAHA.109.130641v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Reichek, N. Articles by Pitt, B. PubMed PubMed Citation Articles by Reichek, N. Articles by Pitt, B. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB AMLODIPINE BESYLATE BENAZEPRIL HYDROCHLORIDE HYDROCHLOROTHIAZIDE Medline Plus Health Information High Blood Pressure Related Collections Remodeling Cardiovascular Pharmacology Hypertrophy CT and MRI Echocardiography

(Hypertension. 2009;54:731.)
© 2009 American Heart Association, Inc.

Original Articles

Magnetic Resonance Imaging Left Ventricular Mass Reduction With Fixed-Dose Angiotensin-Converting Enzyme Inhibitor–Based Regimens in Patients With High-Risk Hypertension

Nathaniel Reichek; Richard B. Devereux; Ricardo A. Rocha; Robert Hilkert; Donna Hall; Das Purkayastha; Bertram Pitt

From the Research Department (N.R.), St Francis Hospital, Roslyn, NY; Stony Brook University (N.R.), Department of Medicine, Division of Cardiology, State University of New York, Stony Brook, NY; Cardiology Division (R.B.D.), Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Novartis Pharmaceuticals Corporation (R.A.R., R.H., D.H., D.P.), East Hanover, NJ; Cardiology Division (B.P.), University of Michigan, Ann Arbor, Mich.

Correspondence to Nathaniel Reichek, Research Department, St Francis Hospital, 100 Port Washington Blvd, Roslyn, NY 11576. E-mail Nathaniel.Reichek{at}chsli.org

Left ventricular hypertrophy, a major cardiovascular risk factor for morbidity and mortality, is commonly caused by arterial hypertension. The renin-angiotensin-aldosterone system may contribute to the pathogenesis of left ventricular hypertrophy. The Assessment of Lotrel in Left Ventricular Hypertrophy and Hypertension Study compared a single-pill combination of amlodipine/benazepril at doses 5.0/20.0 mg, 5.0/40.0 mg, and 10.0/40.0 mg with hydrochlorothiazide/benazepril at doses 12.5/20.0 mg, 12.5/40.0 mg, and 25.0/40.0 mg on the reduction of left ventricular mass index measured by cardiac MRI in stage 2 hypertensive patients over 52 weeks of treatment in a randomized clinical trial. A total of 125 male and female patients, 55 years of age, with echocardiographic left ventricular hypertrophy and high-risk hypertension defined as blood pressure 160/100 mm Hg or current antihypertensive treatment were enrolled. After 52 weeks of treatment, left ventricular mass index was significantly reduced from baseline with amlodipine/benazepril (mean: 10.16 g/m²) or hydrochlorothiazide/benazepril (mean: 6.74 g/m²; both P<0.0001), with a mean difference between treatment groups of 3.36 g/m² (P=0.16). No significant treatment differences were observed in subgroups defined by age, male gender, race, diabetes status, or dose level. However, in female patients, left ventricular mass index reduction was greater with amlodipine/benazepril (P=0.02). Both treatments were well tolerated.

Key Words: hypertension • left ventricular hypertrophy regression • treatment • amlodipine • hydrochlorothiazide • combination therapy