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Women have less LV hypertrophy regression with antihypertensives than men
Hypertension 2008; 52: 100-106
4 July 2008
MedWire News: Women experience less left ventricular (LV) hypertrophy regression with antihypertensive therapy than men, study findings indicate.
Reduction of blood pressure with antihypertensive treatment leads to regression of LV hypertrophy and improved prognosis in hypertensive patients, the researchers explain.
Peter Okin (Cornell University Medical Center, New York, USA) and colleagues examined gender differences on electrocardiogram (ECG) measures of LV hypertrophy in 4230 men and 4963 women with hypertension who were treated with losartan or atenolol.
ECG LV hypertrophy was defined using gender-adjusted Cornell product and Sokolow-Lyon voltage criteria. Above-average regression of hypertrophy was identified by a ≥236 mm·ms reduction in Cornell product or ≥3.5mm reduction in Sokolow-Lyon voltage.
During a mean follow-up of 5 years, women had less reduction in Cornell product (-149 vs -251 mm·ms) and Sokolow-Lyon voltage (-3.0 vs -4.8 mm) than men (both p<0.001).
After adjusting for baseline ECG LV hypertrophy levels, baseline and change in systolic and diastolic pressures, treatment group, age, and other baseline gender differences, women had significantly less reduction than men in both Cornell product (-137 vs -276 mm·ms, p<0.001) and Sokolow-Lyon voltage (-3.6 vs -4.1 mm, p=0.005).
Women were also 32% less likely than men to have greater than the median level of regression of Cornell product LV hypertrophy (p<0.001) and 15% less likely to have regression of LV hypertrophy by Sokolow-Lyon criteria (p=0.003).
Okin and co-workers conclude in the journal Hypertension: "These findings suggest that women may derive less prognostic benefit because of their lesser magnitude and lower likelihood of significant LV hypertrophy regression during antihypertensive therapy.
"Further examination of gender-specific changes in ECG LV hypertrophy during treatment will be required to more fully understand this important issue."
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