Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8667562 | Journal of the American Society of Hypertension | 2016 | 18 Pages |
Abstract
Left ventricular hypertrophy (LVH) predicts cardiovascular risk in hypertensive patients. We analyzed baseline/follow-up electrocardiographies in 26,376 Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial participants randomized to amlodipine (A), lisinopril (L), or chlorthalidone (C). Prevalent/incident LVH was examined using continuous and categorical classifications of Cornell voltage. At 2 and 4 years, prevalence of LVH in the C group (5.57%; 6.14%) was not statistically different from A group (2 years: 5.47%; P = .806, 4 years: 6.54%; P = .857) or L group (2 years: 5.64%; P = .857, 4 years: 6.50%; P = .430). Incident LVH followed similarly, with no difference at 2 years for C (2.99%) compared to A (2.57%; P = .173) or L (3.16%; P = .605) and at 4 years (C = 3.52%, A = 3.29%, L = 3.71%; P = .521 C vs. A, P = .618 C vs. L). Mean Cornell voltage decreased comparably across treatment groups (Î baseline, 2 years = +3 to â27 μV, analysis of variance P = .8612; 4 years = +10 to â17 μV, analysis of variance P = .9692). We conclude that risk reductions associated with C treatment in secondary end points of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial cannot be attributed to differential improvements in electrocardiography LVH.
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Authors
Michael E. PharmD, Barry R. MD, PhD, Elsayed Z. MD, MSc, MS, Ronald J. MB, BS, PhD, Peter M. MD, Alokananda MD, MS, William C. MD, Paula T. MD, MS, Suzanne MD, Richard H. MD, PhD, ALLHAT Collaborative Research Group ALLHAT Collaborative Research Group,