Hypertension, Vol 6, 755-759, Copyright © 1984 by American Heart Association
LA Ferrara, G de Simone, F Pasanisi, M Mancini and M Mancini
Long-term therapy with antihypertensive agents that reduce sympathetic
nervous system activity has been demonstrated by echocardiographic
measurements to reverse left ventricular hypertrophy. This investigation
evaluated the effects of salt depletion obtained by both chlorthalidone (25
mg/day) and severe restriction of salt intake (about 1016 mg Na+/day) on
left ventricular mass (LVM) in as short a time as 12 weeks. Before the
study, the patients had been off medication and on a balanced diet without
salt restriction for at least 2 weeks; they were then randomly allocated to
either the diuretic or low-salt regimen for 6 weeks and finally to
alternative treatment according to a crossover model. Blood pressure, body
weight, myocardial mass, and noninvasive measurements of left ventricular
function (LVF) were determined at baseline and at the end of both periods
of treatment. Results were evaluated by two-way analysis of variance in
randomized blocks. Systolic and diastolic blood pressure and LVM were
significantly and similarly reduced by diuretic therapy or salt
restriction. A significant correlation was demonstrated between noninvasive
measurements of LVM, expressed as cross-sectional area, and systolic blood
pressure. No impairment of LVF could be detected over the treatment period.
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Left ventricular mass reduction during salt depletion in arterial hypertension
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