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(Hypertension. 2007;50:851.)
© 2007 American Heart Association, Inc.

Editorial Commentaries

Left Ventricular Hypertrophy Reversal and Prevention of Diabetes

Two Birds With One Stone?

Giuseppe Schillaci; Matteo Pirro; Elmo Mannarino

From the Unit of Internal Medicine, Angiology and Arteriosclerosis Disease, University of Perugia, Perugia, Italy.

Correspondence to Giuseppe Schillaci, Internal Medicine, Angiology and Arteriosclerosis Disease, University of Perugia Medical School, Hospital "S. Maria della Misericordia," Piazzale Menghini, 1, IT-06129 Perugia, Italy. E-mail: skill@unipg.it

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Left ventricular hypertrophy (LVH) is a strong and independent herald for cardiovascular morbidity and mortality in hypertension.¹ Among the many proposed indexes of hypertensive target-organ damage, LVH stands out as the only available marker of preclinical cardiovascular disease of which the treatment-induced regression has been unequivocally associated to a better prognosis over the next few years, even after accounting for the confounding effect of treatment-induced blood pressure reduction. As summarized in the Table, LVH regression has been shown to have a favorable effect on a wide array of adverse cardiovascular outcomes.^2–9

View this table:   Table. Beneficial Effects of LVH Regression Induced by Antihypertensive Treatment in Individual Studies or Meta-Analyses of Prospective Studies Carried Out in Hypertensive Patients

In the present issue of Hypertension, Okin et al⁹ suggest a novel potential benefit of LVH reversal by demonstrating for the first time a relation between time-varying electrocardiographic LVH and the subsequent development of diabetes. In a large cohort of 7998 nondiabetic hypertensive people with hypertensive LVH drawn from the Losartan Intervention for Endpoint Reduction in Hypertension Study, which was examined prospectively for an average of 4.6 years, regression or persistent absence of LVH on the ECG during antihypertensive treatment was associated with a lower rate of new-onset diabetes. This might be considered in part an anticipated finding, given that treatment with losartan had already been shown in the Losartan Intervention for Endpoint Reduction in Hypertension Study to be more effective than atenolol in reducing both LVH¹⁰ and the incidence of new diabetes.¹¹ Not . . . [Full Text of this Article]

Related Article:

In-Treatment Resolution or Absence of Electrocardiographic Left Ventricular Hypertrophy Is Associated With Decreased Incidence of New-Onset Diabetes Mellitus in Hypertensive Patients: The Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) Study

Peter M. Okin, Richard B. Devereux, Katherine E. Harris, Sverker Jern, Sverre E. Kjeldsen, Lars H. Lindholm, Björn Dahlöf for the LIFE Study Investigators
Hypertension 2007 50: 984-990. [Abstract] [Full Text] [PDF]