Cardiac structural and functional changes during long-term antihypertensive treatment with lacidipine and atenolol in the European Lacidipine Study on Atherosclerosis (ELSA)

Enrico Agabiti-Rosei, Bruno Trimarco, Maria Lorenza Muiesan, John Reid, Antonio Salvetti, Rong Tang, Michael Hennig, Hansjörg Baurecht, Gianfranco Parati, Giuseppe Mancia, Alberto Zanchetti

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objectives: To evaluate and correlate the effects of long-term antihypertensive treatment on left ventricular (LV) mass and carotid structural changes in a large group of essential hypertensive patients, participating in the European Lacidipine Study on Atherosclerosis (ELSA). Design: In four (Brescia, Glasgow, Naples and Pisa) of 23 centres participating in the ELSA study, an echocardiographic examination was performed at baseline and repeated, until the end of the 4-year study, in essential hypertensive patients, followed-up for carotid quantitative ultrasound examination of intima-media thickness (IMT), after random allocation to treatment with either lacidipine or atenolol (and added hydrochlorothiazide, as required for control of blood pressure). Methods: M-mode, two-dimensional guided echocardiography was used to measure left ventricular (LV) wall thickness and dimensions, from which LV mass was calculated, using an anatomically validated formula (Penn Convention) and indexed to body surface area (left ventricular mass index, LVMI). The echocardiographic tracings were blindly evaluated in a single reading centre (Brescia). Bilateral IMT was measured at the site of common carotid and bifurcation far walls (CBMmax). Results: At baseline, cardiac and carotid ultrasound scans were available in 278 patients (mean age 54 ± 7 years, 57% males, 22% obese). A significant correlation was observed between baseline LVMI and CBMmax (r = 0.22, P <0.001), independent of age. In multivariate analysis, CBMmax and mean 24-h pulse pressure were most strongly associated with baseline LVMI. A significant reduction in LVMI was observed both during lacidipine (n = 96) (-12.5% reduction) and atenolol (n = 78) (-13.9% reduction) treatments (up to 4 years) (P <0.001 for both, without significant differences between treatments). Changes in LVMI were not related to changes in carotid wall thickness. In multivariate analysis, baseline LV mass and mean 24-h systolic blood pressure changes were significantly associated with changes in LV mass. Conclusions: In this large, long-term controlled study, antihypertensive treatment with atenolol or lacidipine was accompanied by a similar and significant decrease in LV mass. Treatment-induced changes in LV mass were related to baseline LV mass and changes in 24-h mean systolic blood pressure, without any correlation with changes in carotid structure. In the whole ELSA population, carotid IMT changes have been shown to be unrelated to blood pressure reduction, but significantly influenced by the type of antihypertensive treatment.

Original languageEnglish
Pages (from-to)1091-1098
Number of pages8
JournalJournal of Hypertension
Volume23
Issue number5
Publication statusPublished - May 2005

Fingerprint

Atenolol
Antihypertensive Agents
Atherosclerosis
Blood Pressure
Therapeutics
Multivariate Analysis
Carotid Intima-Media Thickness
Hydrochlorothiazide
Body Surface Area
Random Allocation
lacidipine
Echocardiography
Reading
Population

Keywords

  • Atenolol
  • Carotid atherosclerosis
  • Lacidipine
  • Left ventricular hypertrophy

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology

Cite this

Agabiti-Rosei, E., Trimarco, B., Muiesan, M. L., Reid, J., Salvetti, A., Tang, R., ... Zanchetti, A. (2005). Cardiac structural and functional changes during long-term antihypertensive treatment with lacidipine and atenolol in the European Lacidipine Study on Atherosclerosis (ELSA). Journal of Hypertension, 23(5), 1091-1098.

Cardiac structural and functional changes during long-term antihypertensive treatment with lacidipine and atenolol in the European Lacidipine Study on Atherosclerosis (ELSA). / Agabiti-Rosei, Enrico; Trimarco, Bruno; Muiesan, Maria Lorenza; Reid, John; Salvetti, Antonio; Tang, Rong; Hennig, Michael; Baurecht, Hansjörg; Parati, Gianfranco; Mancia, Giuseppe; Zanchetti, Alberto.

In: Journal of Hypertension, Vol. 23, No. 5, 05.2005, p. 1091-1098.

Research output: Contribution to journalArticle

Agabiti-Rosei, E, Trimarco, B, Muiesan, ML, Reid, J, Salvetti, A, Tang, R, Hennig, M, Baurecht, H, Parati, G, Mancia, G & Zanchetti, A 2005, 'Cardiac structural and functional changes during long-term antihypertensive treatment with lacidipine and atenolol in the European Lacidipine Study on Atherosclerosis (ELSA)', Journal of Hypertension, vol. 23, no. 5, pp. 1091-1098.
Agabiti-Rosei, Enrico ; Trimarco, Bruno ; Muiesan, Maria Lorenza ; Reid, John ; Salvetti, Antonio ; Tang, Rong ; Hennig, Michael ; Baurecht, Hansjörg ; Parati, Gianfranco ; Mancia, Giuseppe ; Zanchetti, Alberto. / Cardiac structural and functional changes during long-term antihypertensive treatment with lacidipine and atenolol in the European Lacidipine Study on Atherosclerosis (ELSA). In: Journal of Hypertension. 2005 ; Vol. 23, No. 5. pp. 1091-1098.
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abstract = "Objectives: To evaluate and correlate the effects of long-term antihypertensive treatment on left ventricular (LV) mass and carotid structural changes in a large group of essential hypertensive patients, participating in the European Lacidipine Study on Atherosclerosis (ELSA). Design: In four (Brescia, Glasgow, Naples and Pisa) of 23 centres participating in the ELSA study, an echocardiographic examination was performed at baseline and repeated, until the end of the 4-year study, in essential hypertensive patients, followed-up for carotid quantitative ultrasound examination of intima-media thickness (IMT), after random allocation to treatment with either lacidipine or atenolol (and added hydrochlorothiazide, as required for control of blood pressure). Methods: M-mode, two-dimensional guided echocardiography was used to measure left ventricular (LV) wall thickness and dimensions, from which LV mass was calculated, using an anatomically validated formula (Penn Convention) and indexed to body surface area (left ventricular mass index, LVMI). The echocardiographic tracings were blindly evaluated in a single reading centre (Brescia). Bilateral IMT was measured at the site of common carotid and bifurcation far walls (CBMmax). Results: At baseline, cardiac and carotid ultrasound scans were available in 278 patients (mean age 54 ± 7 years, 57{\%} males, 22{\%} obese). A significant correlation was observed between baseline LVMI and CBMmax (r = 0.22, P <0.001), independent of age. In multivariate analysis, CBMmax and mean 24-h pulse pressure were most strongly associated with baseline LVMI. A significant reduction in LVMI was observed both during lacidipine (n = 96) (-12.5{\%} reduction) and atenolol (n = 78) (-13.9{\%} reduction) treatments (up to 4 years) (P <0.001 for both, without significant differences between treatments). Changes in LVMI were not related to changes in carotid wall thickness. In multivariate analysis, baseline LV mass and mean 24-h systolic blood pressure changes were significantly associated with changes in LV mass. Conclusions: In this large, long-term controlled study, antihypertensive treatment with atenolol or lacidipine was accompanied by a similar and significant decrease in LV mass. Treatment-induced changes in LV mass were related to baseline LV mass and changes in 24-h mean systolic blood pressure, without any correlation with changes in carotid structure. In the whole ELSA population, carotid IMT changes have been shown to be unrelated to blood pressure reduction, but significantly influenced by the type of antihypertensive treatment.",
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author = "Enrico Agabiti-Rosei and Bruno Trimarco and Muiesan, {Maria Lorenza} and John Reid and Antonio Salvetti and Rong Tang and Michael Hennig and Hansj{\"o}rg Baurecht and Gianfranco Parati and Giuseppe Mancia and Alberto Zanchetti",
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TY - JOUR

T1 - Cardiac structural and functional changes during long-term antihypertensive treatment with lacidipine and atenolol in the European Lacidipine Study on Atherosclerosis (ELSA)

AU - Agabiti-Rosei, Enrico

AU - Trimarco, Bruno

AU - Muiesan, Maria Lorenza

AU - Reid, John

AU - Salvetti, Antonio

AU - Tang, Rong

AU - Hennig, Michael

AU - Baurecht, Hansjörg

AU - Parati, Gianfranco

AU - Mancia, Giuseppe

AU - Zanchetti, Alberto

PY - 2005/5

Y1 - 2005/5

N2 - Objectives: To evaluate and correlate the effects of long-term antihypertensive treatment on left ventricular (LV) mass and carotid structural changes in a large group of essential hypertensive patients, participating in the European Lacidipine Study on Atherosclerosis (ELSA). Design: In four (Brescia, Glasgow, Naples and Pisa) of 23 centres participating in the ELSA study, an echocardiographic examination was performed at baseline and repeated, until the end of the 4-year study, in essential hypertensive patients, followed-up for carotid quantitative ultrasound examination of intima-media thickness (IMT), after random allocation to treatment with either lacidipine or atenolol (and added hydrochlorothiazide, as required for control of blood pressure). Methods: M-mode, two-dimensional guided echocardiography was used to measure left ventricular (LV) wall thickness and dimensions, from which LV mass was calculated, using an anatomically validated formula (Penn Convention) and indexed to body surface area (left ventricular mass index, LVMI). The echocardiographic tracings were blindly evaluated in a single reading centre (Brescia). Bilateral IMT was measured at the site of common carotid and bifurcation far walls (CBMmax). Results: At baseline, cardiac and carotid ultrasound scans were available in 278 patients (mean age 54 ± 7 years, 57% males, 22% obese). A significant correlation was observed between baseline LVMI and CBMmax (r = 0.22, P <0.001), independent of age. In multivariate analysis, CBMmax and mean 24-h pulse pressure were most strongly associated with baseline LVMI. A significant reduction in LVMI was observed both during lacidipine (n = 96) (-12.5% reduction) and atenolol (n = 78) (-13.9% reduction) treatments (up to 4 years) (P <0.001 for both, without significant differences between treatments). Changes in LVMI were not related to changes in carotid wall thickness. In multivariate analysis, baseline LV mass and mean 24-h systolic blood pressure changes were significantly associated with changes in LV mass. Conclusions: In this large, long-term controlled study, antihypertensive treatment with atenolol or lacidipine was accompanied by a similar and significant decrease in LV mass. Treatment-induced changes in LV mass were related to baseline LV mass and changes in 24-h mean systolic blood pressure, without any correlation with changes in carotid structure. In the whole ELSA population, carotid IMT changes have been shown to be unrelated to blood pressure reduction, but significantly influenced by the type of antihypertensive treatment.

AB - Objectives: To evaluate and correlate the effects of long-term antihypertensive treatment on left ventricular (LV) mass and carotid structural changes in a large group of essential hypertensive patients, participating in the European Lacidipine Study on Atherosclerosis (ELSA). Design: In four (Brescia, Glasgow, Naples and Pisa) of 23 centres participating in the ELSA study, an echocardiographic examination was performed at baseline and repeated, until the end of the 4-year study, in essential hypertensive patients, followed-up for carotid quantitative ultrasound examination of intima-media thickness (IMT), after random allocation to treatment with either lacidipine or atenolol (and added hydrochlorothiazide, as required for control of blood pressure). Methods: M-mode, two-dimensional guided echocardiography was used to measure left ventricular (LV) wall thickness and dimensions, from which LV mass was calculated, using an anatomically validated formula (Penn Convention) and indexed to body surface area (left ventricular mass index, LVMI). The echocardiographic tracings were blindly evaluated in a single reading centre (Brescia). Bilateral IMT was measured at the site of common carotid and bifurcation far walls (CBMmax). Results: At baseline, cardiac and carotid ultrasound scans were available in 278 patients (mean age 54 ± 7 years, 57% males, 22% obese). A significant correlation was observed between baseline LVMI and CBMmax (r = 0.22, P <0.001), independent of age. In multivariate analysis, CBMmax and mean 24-h pulse pressure were most strongly associated with baseline LVMI. A significant reduction in LVMI was observed both during lacidipine (n = 96) (-12.5% reduction) and atenolol (n = 78) (-13.9% reduction) treatments (up to 4 years) (P <0.001 for both, without significant differences between treatments). Changes in LVMI were not related to changes in carotid wall thickness. In multivariate analysis, baseline LV mass and mean 24-h systolic blood pressure changes were significantly associated with changes in LV mass. Conclusions: In this large, long-term controlled study, antihypertensive treatment with atenolol or lacidipine was accompanied by a similar and significant decrease in LV mass. Treatment-induced changes in LV mass were related to baseline LV mass and changes in 24-h mean systolic blood pressure, without any correlation with changes in carotid structure. In the whole ELSA population, carotid IMT changes have been shown to be unrelated to blood pressure reduction, but significantly influenced by the type of antihypertensive treatment.

KW - Atenolol

KW - Carotid atherosclerosis

KW - Lacidipine

KW - Left ventricular hypertrophy

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