Possible regression of left ventricular hypertrophy during antihypertensive treatment with diuretics and/or beta blockers.

The possible regression of left ventricular hypertrophy (LVH) during treatment with diuretics and/or beta blockers was assessed in 78 hypertensive patients by echocardiography. Five groups of patients were treated, respectively, with diuretics alone, chlorthalidone plus SR oxprenolol, acebutolol followed by atenolol, timolol alone, or atenolol alone. All patients, except those receiving acebutolol had a significantly reduced LV mass within 12 months. Acebutolol did not modify LV mass even after 24 months, in spite of its antihypertensive efficacy. The reduction of LV mass was due to a decrease in wall thickness after administration of beta blockers and a decrease in LV dimension after chlorthalidone. Normalization of LV mass (less than 130 g/m2) occurred only in 31% of patients. LV mass was not significantly modified in patients with normal mass in pretreatment condition. The decrease of LV mass correlated with a decrease in cardiac output but not with the reduction in blood pressure. In conclusion, LV systolic function showed a tendency toward improvement after long-term antihypertensive therapy.