Does Intensive BP Control Improve Left Ventricular Hypertrophy?

Intensive blood pressure (BP) lowering can reduce the risk of left ventricular hypertrophy (LVH) or improve existing LVH in patients with hypertension but without diabetes, according to the findings of a new study.

The researchers analyzed data from 8164 participants with hypertension but without diabetes who were involved in the Systolic Blood Pressure Intervention (SPRINT) Trial (mean age 67.9 years, 35.3% were women). In the SPRINT trial, 4078 participants were randomly assigned intensive BP lowering and 4078 were assigned to standard BP lowering. Baseline and biannual measurements of LVH were compared between groups over the 3.81 years of follow-up. Effects of BP lowering on primary CVD outcomes, including myocardial infarction, acute coronary syndrome, stroke, heart failure, and CVD-related death, were compared as well.
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In the 7559 participants without baseline LVH, intensive BP lowering was associated with a 46% lower risk of developing LVH compared with those who were assigned standard BP lowering. Participants with LVH at baseline assigned to intensive BP lowering were 66% more likely to experience regression or improvement in LVH compared with those who received standard BP treatment.

“Among patients with hypertension but no diabetes, intensive BP lowering (target systolic BP<120 mmHg), compared with standard BP lowering (target systolic BP<140 mmHg), resulted in lower rates of developing new LVH in those without LVH, and higher rates of regression of LVH in those with existing LVH,” the researchers concluded. “This favorable effect on LVH did not explain most of the reduction in CVD events associated with intensive BP lowering in the SPRINT trial.”

—Melissa Weiss

Reference:

Soliman EZ, Ambrosius WT, Cushman WC, et al. Effect of intensive blood pressure lowering on left ventricular hypertrophy in patients with hypertension: the Systolic Blood Pressure Intervention (SPRINT) Trial [published online May 16, 2017]. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.117.028441