Reversal of left ventricular hypertrophy in hypertensive patients treated with methyldopa. Lack of association with blood pressure control.

Ten patients with essential hypertension and left ventricular hypertrophy were treated with relatively small doses of methyldopa (500 to 750 mg/day) added to long-term diuretic therapy. Sequential M mode echocardiography showed significant reduction in left ventricular mass 36 weeks after addition of methyldopa in four patients (359 +/- 77 [standard error of the mean] to 235 +/- 63 g) although blood pressure was not significantly altered by the added treatment. In three of these patients, reduction of left ventricular mass was observed as early as 12 weeks of treatment (384 to 262 g). Neither left ventricular mass to left ventricular volume ratio nor fractional shortening was significantly altered by reduction in left ventricular mass (3.21 +/- 0.26 to 2.74 +/- 0.24 and 0.42 +/- 0.03 to 0.44 +/- 0.02, respectively). There was no apparent relation in these patients between changes in blood pressure and changes in left ventricular mass. Thus, reversal of cardiac hypertrophy with antihypertensive treatment is possible in human beings; however, it seems to depend on other factors besides blood pressure control.