Regression of left ventricular hypertrophy in the short-term treatment of hypertension with isradipine.

This was a study of the effectiveness of isradipine, a calcium antagonist of the dihydropyridine group, in reversing left ventricular hypertrophy (LVH) in patients with mild-to-moderate hypertension. Mean arterial pressure was effectively reduced at 90 days of treatment (from 129.5 +/- 2.0 to 111.5 +/- 2.8 mm Hg; P less than .001). The electrocardiographic Romhilt-Estes score for LVH showed early reduction at 45 days of treatment (from 7.1 +/- 0.6 to 5.1 +/- 0.4 points; P less than .001), and further diminutions were observed at 90 days of treatment (3.8 +/- 0.4 points; P less than .01). The echocardiographically determined left ventricular mass indices confirmed these findings (from 175.0 +/- 8.9 to 141.7 +/- 5.5 and to 124.8 +/- 4.2 g/m2; P less than .001) for 45 and 90 days, respectively. The results indicate that isradipine is effective in reducing left ventricular mass and that these reductions are observed early in the course of treatment.

Reversal of left ventricular hypertrophy following treatment of hypertension with isradipine.

In order to complement earlier short-term observations, we studied the effects of isradipine (1.25 or 2.5 mg twice daily) on blood pressure as well as its action in reversing cardiac hypertrophy in 25 moderately hypertensive patients. We observed that the treatment produced short-term (3 month) and longer-term (9 month) control of blood pressure [decreases in mean arterial pressure (MAP) from 128 +/- 2.3 to 112 +/- 2.7 mm Hg and to 105.5 +/- 2.9 mm Hg; p less than 0.001] while heart rate remained constant throughout the study (from 76.6 +/- 2.3 to 74.7 +/- 2.4 beats/min; NS). Reversal of left ventricular hypertrophy (LVH) obtained after 3 months of treatment (LV mass index from 173.7 +/- 8.8 to 135.7 +/- 4.5 g/m2; p less than 0.001) was accentuated with continued therapy (to 131.0 +/- 4.0 and 124.4 +/- 3.1 g/m2 at 6 and 9 months, respectively; p less than 0.01). These results indicate that significant regression of LVH can be obtained with short-term treatment of hypertension with isradipine and that this effect will be fully obtained with longer-term (9 month) therapy.