Regression of left ventricular mass in hypertensive patients treated with perindopril/indapamide as a first-line combination: The REASON echocardiography study

Nicola De Luca, Jean Michel Mallion, Michael F. O'Rourke, Eoin O'Brien, Karl Heinz Rahn, Bruno Trimarco, Ramon Romero, Peter Wilhelmus De Leeuw, Gerhart Hitzenberger, Edouard Battegay, Daniel Duprez, Peter Sever, Michel E. Safar

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Abstract

Increase in left ventricular mass (LVM) may be linked to morbidity and mortality in hypertensive patients. Arterial stiffness, systolic blood pressure (BP), and pulse pressure (PP) seem to be the main determinants of LVM. The perindopril/indapamide combination normalizes systolic BP, PP, and arterial function to a greater extent than atenolol. The aim of this study was to compare the effects of perindopril (2 mg)/indapamide (0.625 mg) first-line combination with atenolol (50 mg) on LVM reduction in hypertensive patients. Two hundred fourteen patients with essential hypertension participating in the PREterax in Regression of Arterial Stiffness in a ContrOlled Double-BliNd (REASON), randomized, double-blind, parallel-group study, underwent M-mode two-dimensional-guided echocardiography. Perindopril/indapamide and atenolol were both effective at brachial BP reduction during the 12-month period. The systolic BP reduction was significantly greater with perindopril/indapamide than with atenolol (-21.2 v -15.3 mm Hg), whereas the reduction in diastolic BP was similar between treatment groups (-12.1 v -11.3 mm Hg). Reduction in LVM was higher with perindopril/indapamide than with atenolol. The between-group difference was significant for LVM (-13.6 v -4.3 g, P =. 027), LVM/body surface area (LVMI1, P =. 032), and LVM/body height2.7 (LVMI 2, P =. 013). The 124 patients with LV hypertrophy at baseline showed greatest LVM regression (LVM: -22.5 v -8.9 g, P =. 009; LVMI1, P =. 031; LVMI2, P =. 028). The reduction in LVM adjusted for brachial systolic BP and heart rate was still significantly greater with perindopril/indapamide than with atenolol. Treatment, based on a first-line perindopril/indapamide combination in hypertensive patients, was more effective than atenolol on regression of echocardiographic indices of LVM and LV hypertrophy.

Original languageEnglish (US)
Pages (from-to)660-667
Number of pages8
JournalAmerican journal of hypertension
Volume17
Issue number8
DOIs
StatePublished - Aug 2004

Keywords

  • Echocardiography
  • Hypertension
  • Left ventricular hypertrophy
  • Left ventricular mass
  • Perindopril/indapamide combination

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    De Luca, N., Mallion, J. M., O'Rourke, M. F., O'Brien, E., Rahn, K. H., Trimarco, B., Romero, R., De Leeuw, P. W., Hitzenberger, G., Battegay, E., Duprez, D., Sever, P., & Safar, M. E. (2004). Regression of left ventricular mass in hypertensive patients treated with perindopril/indapamide as a first-line combination: The REASON echocardiography study. American journal of hypertension, 17(8), 660-667. https://doi.org/10.1016/S0895-7061(04)00815-5