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. 2025 Mar 28;14(7):2313.
doi: 10.3390/jcm14072313.

Electrocardiographic Left Ventricular Mass Trajectories and the Effects of Treatment in Patients at Different Stages of Hypertension

Flávio D Fuchs  1 , Leonardo Krause Valter  1 , Arthur Lacerda Tavares  1 , Beatriz Padoin Camilo  1 , Paul K Whelton  2 , Luiz C N Scala  3 , José F Vilela-Martin  4 , Carlos E Poli-de-Figueiredo  5 , Ricardo Pereira E Silva  6 , Miguel Gus  1 , Luiz A Bortolotto  7 , Rosane P Schlatter  1 , Evandro J Cesarino  8 , Iran Castro  9 , José A Figueiredo Neto  10 , André A Steffens  11 , João G Alves  12 , Andréa A Brandão  13 , Marcos R de Sousa  14 , Paulo C Jardim  15 , Leila B Moreira  1 , Roberto S Franco  16 , Marco M Gomes  17 , Felipe C Fuchs  1 , Dario Sobral Filho  18 , Antônio C Nóbrega  19 , Fernando Nobre  20 , Otávio Berwanger  21 , Sandra C Fuchs  1
Affiliations

Electrocardiographic Left Ventricular Mass Trajectories and the Effects of Treatment in Patients at Different Stages of Hypertension

Flávio D Fuchs et al. J Clin Med. .

Abstract

Background: The comparison of left ventricular mass (LVM) at different BP levels and the effects of antihypertensive drug treatment on LVM are unknown. Objective: To compare the LVM of individuals with prehypertension and Stage 1 hypertension and assess the effects of treatment on LVM at these stages of hypertension. Methods: We estimated LVM in the PREVER-Prevention trial using Sokolow-Lyon and Cornell voltage and voltage-duration products before and after randomization to 18 months of treatment with low doses of chlorthalidone and amiloride or placebo in adults with JNC 7 "prehypertension" (systolic BP [SBP] of 120-139 mm Hg and diastolic BP [DBP] of 80-89 mm Hg). Similarly, in the PREVER-Treatment trial, we assessed these indices before and after randomization to 18 months of treatment with the chlorthalidone/amiloride combination or losartan in adults with JNC 7 "stage 1" hypertension (140-159 mm Hg or DBP of 90-99 mm Hg). Results: At baseline, the participants in the stage I hypertension trial exhibited higher mean LVM indices than those in the prehypertension trial. In the PREVER-Prevention trial, those randomized to the chlorthalidone/amiloride combination experienced a significant reduction in Sokolow-Lyon LVM indices compared to placebo (p = 0.02). In the PREVER-Treatment trial, those randomized to the chlorthalidone/amiloride combination or losartan experienced a similar reduction in electrocardiographic LVM during the 18 months of treatment (p < 0.01). Conclusions: The institution of low-dose antihypertensive drug therapy in prehypertension and treatment of patients with stage 1 hypertension has the potential to interrupt the progress of hypertensive cardiomyopathy.

Keywords: Cornell product; S-L voltage; blood pressure; electrocardiography; hypertension; left ventricular mass; treatment.

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Conflict of interest statement

Authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The sponsors had no participation in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Figures

Figure 1
Figure 1
LVM trajectories and treatment effects in patients with prehypertension and hypertension estimated by the Sokolow–Lyon and Cornell voltage criteria.
See this image and copyright information in PMC

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