REDUCTION OF LEFT-VENTRICULAR HYPERTROPHY AFTER LONG-TERM ANTIHYPERTENSIVE TREATMENT WITH DOXAZOSIN

The aim of this study was to evaluate the effect of antihypertensive t reatment with doxazosin on left ventricular anatomy and function. Ther efore, after 4 weeks of washout with placebo (phase 1), doxazosin (dos age range from 1 to 16 mg, plus hydrochlorothiazide when necessary) wa s given to 11 essential hypertensive patients (6 M, 5 F, age range 34- 63 years) for 8 weeks (phase 2) in order to achieve diastolic blood pr essure values < 90 mmHg; this dosage was then maintained for a further 20 weeks up to the end of the study (phase 3). Blood pressure was sig nificantly reduced (Anova P < 0.05), while heart rate did not change. A significant reduction of left ventricular mass index (from 128.5 +/- 26 to 114 +/- 23 g/m2, at the end of phase 1 and 3 respectively, P < .001)) was observed. Before and during treatment left ventricular syst olic function, both at rest and during stress (handgrip and cold press or tests), evaluated by fractional shortening as related to end-systol ic stress, in every case within 95% confidence limits, was calculated in normal subjects. Diastolic function, as evaluated by the ratio betw een peak early and atrial velocities of transmitral flow examined by p ulsed doppler was significantly improved. Plasma catecholamine concent rations, plasma renin activity and plasma aldosterone did not change. A significant reduction of plasma cholesterol concentration was observ ed. These results confirm that doxazosin is a well tolerated and effec tive antihypertensive drug, with a favourable effect on blood lipids a nd they indicate that its longterm administration can induce a signifi cant reduction of left ventricular mass.