SIGNIFICANCE OF BLOOD-PRESSURE LEVELS ACHIEVED WITH FELODIPINE ANTIHYPERTENSIVE TREATMENT ON CARDIOVASCULAR STRUCTURE AND FUNCTION CHANGES

One of the targets of anti-hypertensive treatment is cardiovascular st ructural and functional improvements, while the level of blood pressur e (BP) under treatment is related to patient morbidity and mortality. The aim of this study was to evaluate the relation of BP achieved afte r felodipine monotherapy to the degree of cardiovascular changes. Six hundred patients with essential hypertension were studied and grouped according to diastolic BP (DBP) levels after 6 months of therapy: 90-9 4 (n = 86), 85-89 (n = 186), 80-84 (n = 180) and < 80 mm Hg (n = 148). Overall BP fell from 175/103 to 137/83 mm Hg with a concomitant moder ate reflex tachycardia (3.3%). Left ventricular (LV) dimensions decrea sed to a degree (-0.4 and -0.8%, P < 0.0001), with the greatest decrea se in patients with lower DBP levels under treatment (P < 0.0001), LV systolic function improved to a modest degree (0.8%, P < 0.0001), depe nding on DBP fall (P < 0.0001), as did cardiac output (2.4%, P < 0.000 1). LV systolic wall stress and total peripheral resistance fell (-18% and -14%, P < 0.0001) in relation to DBP drop (P < 0.0001), as did ao rtic root distensibility (55%, P < 0.0001). It is concluded that the d egree of cardiovascular structure and function improvements are direct ly related to the DBP levels achieved under felodipine anti-hypertensi ve therapy.