ASSOCIATION OF CHANGE IN LEFT-VENTRICULAR MASS WITH PROGNOSIS DURING LONG-TERM ANTIHYPERTENSIVE TREATMENT

Objective: The aim of the present study was to assess the prognostic v alue of changes in left ventricular hypertrophy in hypertensive patien ts with time. Design: Two hundred and fifteen uncomplicated hypertensi ve patients underwent a high-quality baseline echocardiogram for left ventricular anatomy evaluation and in 151 of those patients the echoca rdiographic examination was repeated 10 +/- 1.4 years after the initia l study. Methods: Left ventricular mass index changes were evaluated, in relation to the incidence of non-fatal cardiovascular events, adjus ted for traditional cardiovascular risk factors. Results: According to the presence or absence of left ventricular hypertrophy (left ventric ular mass index > 134 g/m(2) in men and > 110 g/m(2) in women) at base line and at the end of follow-up study, patients were divided into fou r groups: with normal left ventricular mass at both examinations (n = 78), with regression of left ventricular hypertrophy (n = 32), with pe rsistence of left ventricular hypertrophy (n = 34) and with hypertroph y development (n = 7). After adjustment for traditional cardiovascular risk factors, the cumulative incidence of non-fatal cardiovascular ev ents was significantly higher in the group of patients without regress ion of left ventricular hypertrophy. Cox survival analysis showed the presence of left ventricular hypertrophy at the end of follow-up study to be the most important factor related to cardiovascular events. Con clusions: The present findings strongly indicate that the lack of decr ease or the increase of left ventricular mass after antihypertensive t reatment can be associated with a higher risk for cardiovascular event s, which is significantly reduced and almost normalized by complete re gression of left ventricular hypertrophy.