הסקירה באדיבות מדיקונטקסט:Last Updated: 2001-07-25 8:39:24 EDT (Reuters Health)
By Will Boggs, MD
WESTPORT, CT (Reuters Health) – Antihypertensive treatment with certain drugs reduces left ventricular hypertrophy, cardiac arrhythmias, and transient episodes of myocardial ischemia, according to a report in the July issue of the American Journal of Hypertension.
Over a 6-month treatment period, Dr. Salvatore Novo from the University of Palermo in Italy and colleagues evaluated the effects of atenolol, enalapril, verapamil, and hydrochlorothiazide in 46 hypertensive patients with left ventricular hypertrophy but no clinical history of coronary heart disease.
All four drugs brought significant declines in blood pressure, the investigators found. However, hydrochlorothiazide treatment failed to result in a significant decrease in left ventricular mass.
The number of transient episodes of myocardial ischemia decreased after 6 months of treatment (by 51%, p = 0.043), and the reduction was more obvious when hydrochlorothiazide-treated patients were excluded from the analysis (61% reduction, p = 0.013).
Similarly, the researchers note, the prevalence of supraventricular and ventricular arrhythmias fell significantly after treatment, and again the reduction was more evident after the exclusion of hydrochlorothiazide-treated patients.
Rather than being a primary treatment for hypertension, Dr. Novo told Reuters Health, "hydrochlorothiazide is useful as a drug of association with another antihypertensive drug."
Dr. Novo also suggested that using the effective drugs (atenolol, enalapril, verapamil) in different combinations "may have an additive effect in reducing blood pressure and so, indirectly, may favor a reduction of transient episodes of myocardial ischemia and cardiac arrhythmias."
Am J Hypertens 2001;14:637-643.
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