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Atenolol + nifedipine provides rapid regression of hypertension­associated left ventricular hypertrophy

Almost complete regression of left ventricular hypertrophy occurred in 82% of patients with hypertension after 5 years of treatment with varied regimens of beta blockers, calcium antagonists and enalapril. Although all the drug regimens were effective, significantly greater regression occurred with the combination of atenolol + nifedipine during the first year of treatment; BP reduction was also similar in all patients. The regression of left ventricular hypertrophy may decrease cardiovascular risk by 25%.

122 patients with untreated essential hypertension and left ventricular hypertrophy proven by ECG, received gallopamil 100-150 mg/day (n = 26; group 1), metoprolol 200 mg/day (25; group 2), atenolol 50 mg/day + nifedipine 20 mg/day (36; group 3), acebutolol 200 mg/day + nifedipine 20 mg/day (14; group 4), or atenolol 50 mg/day + enalapril 10 mg/day (21; group 5).

After 7 months of treatment, the left ventricular mass index was reduced by 17.7% in group 1, 22.6% in group 2, 31.2% in group 3, 27.7% in group 4, and 21.5% in group 5. These reductions continued over the next 4 years, and achieved near normality in all groups (mean reduction 44.1 %). The interventricular septal and posterior wall thicknesses were similarly decreased, and the relative wall thicknesses were almost normal after 5 years. Additionally, a 16% increase in fractional fibre shortening occurred, starting after the second year of therapy.

The authors concluded that the drugs of first choice in hypertension should be those proven to produce regression of left ventricular hypertrophy and improve cardiac pump function in the long term. Franz I-W, Ketelhut R, Behr U, T6nnesmann U, Long - term studies on regression of left ventricular hypertrophy. Journal of Cardiovascular Pharmacology 17 (Suppl. 2): 87-93, 1991 ""

20 Jul1991 INPHARMA® ISSN 0156-2703/91/0720-0018/0$01.00/0 e Adis InttrlUltionfll Ltd