Lowering LVH Cuts Heart Attack Risk

Two new studies found that lowering left ventricular hypertrophy(LVH) with hypertension medications can further reduce therisk of heart problems in patients whose blood pressure hasbeen significantly lowered. The results of the studies, reported inthe Journal of the American Medical Association (November 17,2004), are based on research from 9193 men and women withhigh blood pressure. The participants were being treated witheither losartan or the beta-blocker atenolol.

In one study, the researchers evaluated rates of heart attacks,strokes, and related deaths over 5 years. Using electrocardiograms,LVH was measured annually. The findings showed thatpatients whose tests indicated significant LVH reduction were 29%less likely to have cardiovascular-related deaths and nonfatal heartattacks and strokes, compared with those patients whose LVH wasunchanged. In the second study involving a subset of patients testedwith echocardiograms, the researchers found similar results.

Because hypertension is the most common cause of LVH,Peter Okin, MD, lead author of one study, recommended that allpatients with high blood pressure should be tested for LVH periodicallythroughout treatment. Patients whose LVH is not gettingbetter or getting worse should be treated more aggressively, Dr.Okin added. The American Heart Association disagreed, claimingthat routine tests to examine LVH in patients are too costlyand premature. A spokesman for the association, Daniel Jones,MD, said the results of the 2 studies were small, and loweringpatients'blood pressure should remain a top priority.