Oliván J, Moreno R, Hoyos M, Ramos E, Rodríguez A, Pizarro J L, Justo E, Pérez Cano R
Departamento de Medicina, Unidad de Hipertensión Arterial y Factores de Riesgo, Hospital Universitario Virgen Macarena, Sevilla.
An Med Interna. 1996 Nov;13(11):531-6.
Left ventricular hypertrophy (LVH) is one of the physiopathological effects of hypertension and one of the main risk factors for sudden death, myocardial infarction and congestive heart failure. Drugs to treat hypertension must not only reduce blood pressure, but also modify the facts which lead to ventricular hypertrophy. This study has been designed to assess the effect of amlodipine, a calcium-antagonist, on LVH in hypertensive patients.
20 hypertensive patients (mild to moderate, both sexes, mean age 45.0 yr) were included in a single-blind study. After an initial, four weeks placebo period, active treatment was given (amlodipine 5 mg a day). Dose titration was made after 4-8 weeks to 10 mg a day if necessary and continued until the end of the study. Systolic (SBP) and diastolic blood pressure (DBP), as well as pulse rate (PR) and adverse events were recorded at every visit. Blood and urine analysis, catecholamine, plasmatic renin activity and Mode M echocardiography were made at the beginning and the end of the study.
Only one patient was excluded. SBP and DBP showed a significantly fall (p < 0.001). In 80% of patients DBP fell under 90 mm Hg. Every echocardiographic parameter, but left ventricular diastolic dimension, showed significantly reductions at the end of the study: septum thickness (p = 0.001), posterior wall thickness (p = 0.001), left ventricular systolic dimension (p = 0.014), wall relative thickness (p = 0.015), shortening fraction (p = 0.009), left ventricular mass (p = 0.001) and corrected left ventricular mass (p = 0.001). Blood parameters did not modify.
Amlodipine has a beneficial effect on LVH and also is an effective and safe drug to treat mild to moderate hypertension.
左心室肥厚（LVH）是高血压的生理病理效应之一，也是猝死、心肌梗死和充血性心力衰竭的主要危险因素之一。治疗高血压的药物不仅要降低血压，还必须改变导致心室肥厚的因素。本研究旨在评估钙拮抗剂氨氯地平对高血压患者左心室肥厚的影响。
20例高血压患者（轻度至中度，男女均有，平均年龄45.0岁）纳入单盲研究。经过为期4周的初始安慰剂期后，给予积极治疗（氨氯地平每日5毫克）。必要时在4 - 8周后将剂量滴定至每日10毫克，并持续至研究结束。每次就诊时记录收缩压（SBP）、舒张压（DBP）以及脉率（PR）和不良事件。在研究开始和结束时进行血液和尿液分析、儿茶酚胺、血浆肾素活性和M型超声心动图检查。
仅1例患者被排除。收缩压和舒张压显著下降（p < 0.001）。80%的患者舒张压降至90毫米汞柱以下。除左心室舒张内径外，所有超声心动图参数在研究结束时均显著降低：室间隔厚度（p = 0.001）、后壁厚度（p = 0.001）、左心室收缩内径（p = 0.014）、室壁相对厚度（p = 0.015）、缩短分数（p = 0.009）、左心室质量（p = 0.001）和校正后左心室质量（p = 0.001）。血液参数未改变。
氨氯地平对左心室肥厚有有益作用，也是治疗轻度至中度高血压的有效且安全的药物。
