Effects of Antihypertensive Therapy with Amlodipine on Left Ventricular Mass and Diastolic Function

The effect of antihypertensive therapy with amlodipine on left ventricular mass and diastolic function was examined. After a wash-out period of 2 weeks and a single-blind placebo period of 4 weeks, patients found to have mild to moderate systemic heypertension, left ventricular hypertrophy (LVH) and diastolic dysfunction (DD) with echo-Doppler were included in the study. LVH was described as left ventricular mass index (LVMI) > 134 g/m2 in men and > 110 g/m2 in women and DD as mitral inflow E/A < 1. Amlodipine was given 5 mg daily and if neccessary was increased to 10 mg in the 4th week and continued for 6 months. 30 patients in the sixth month with controlled hypertension were reevaluated. Blood pressure decreased from 164±13/104±6 to 134±10/84±5 in the 3rd month (p<0.01) and to 131±10/85±5 mmHg in the 6th month. LVMI decreased from 157.7±30 to 135.7±27.2 in the 3rd month (p<0.01) and to 131.8±24.9 g/m2 in the 6th month (p<0.01). The regression of LVH was seen to be due mainly on the regression of septal thickness (12.8±0.2 baseline, 11.7±1.8 in 3 months p<0.05, and 11.2±1.8 p<0.01, in 6 months). Although a small improvement in E/A ratio was observed in 6 months, the change was not significant. In conclusion; 1) amlodipine was found to be effective in reducing LVH in patients with mild to moderate hypertension, 2) the regression in LVH was persistent in 6 months, 3) the regression in LVH was mainly due to regression in septal thickness and 4) despite blood pressure control and regression in left ventricular mass, a significant improvement in diastolic function was not achieved.