Journal article
Electrocardiographic measures of left ventricular hypertrophy in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
Journal of the American Society of Hypertension, Vol.10(12), pp.930-938.e9
12/2016
DOI: 10.1016/j.jash.2016.10.010
PMCID: PMC5161112
PMID: 27938852
Abstract
Left ventricular hypertrophy (LVH) predicts cardiovascular risk in hypertensive patients. We analyzed baseline/follow-up electrocardiographies in 26,376 Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial participants randomized to amlodipine (A), lisinopril (L), or chlorthalidone (C). Prevalent/incident LVH was examined using continuous and categorical classifications of Cornell voltage. At 2 and 4 years, prevalence of LVH in the C group (5.57%; 6.14%) was not statistically different from A group (2 years: 5.47%; P = .806, 4 years: 6.54%; P = .857) or L group (2 years: 5.64%; P = .857, 4 years: 6.50%; P = .430). Incident LVH followed similarly, with no difference at 2 years for C (2.99%) compared to A (2.57%; P = .173) or L (3.16%; P = .605) and at 4 years (C = 3.52%, A = 3.29%, L = 3.71%; P = .521 C vs. A, P = .618 C vs. L). Mean Cornell voltage decreased comparably across treatment groups (Δ baseline, 2 years = +3 to −27 μV, analysis of variance P = .8612; 4 years = +10 to −17 μV, analysis of variance P = .9692). We conclude that risk reductions associated with C treatment in secondary end points of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial cannot be attributed to differential improvements in electrocardiography LVH.
•The comparative effects of chlorthalidone and other antihypertensives on electrocardiography (ECG) left ventricular hypertrophy (LVH) are unknown.•Antihypertensive and Lipid-Lowering to Prevent Heart Attack Trial data were analyzed to determine the changes in ECG LVH through 2 and 4 years of follow-up.•Chlorthalidone led to similar overall change in ECG Cornell voltage as amlodipine and lisinopril.•Chlorthalidone's benefit in Antihypertensive and Lipid-Lowering to Prevent Heart Attack Trial cannot be attributed to a greater reduction in ECG LVH.
Details
- Title: Subtitle
- Electrocardiographic measures of left ventricular hypertrophy in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
- Creators
- Michael E. Ernst - University of IowaBarry R. Davis - Coordinating Center for Clinical Trials, Department of Biostatistics, University of Texas School of Public Health, Houston, TX, USA.Elsayed Z. Soliman - Wake Forest UniversityRonald J. Prineas - Wake Forest UniversityPeter M. Okin - Cornell UniversityAlokananda Ghosh - Coordinating Center for Clinical Trials, Department of Biostatistics, University of Texas School of Public Health, Houston, TX, USA.William C. Cushman - Veterans Health AdministrationPaula T. Einhorn - National Heart Lung and Blood InstituteSuzanne Oparil - University of Alabama at BirminghamRichard H. Grimm - University of MinnesotaALLHAT Collaborative Research Group
- Resource Type
- Journal article
- Publication Details
- Journal of the American Society of Hypertension, Vol.10(12), pp.930-938.e9
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jash.2016.10.010
- PMID
- 27938852
- PMCID
- PMC5161112
- ISSN
- 1933-1711
- eISSN
- 1878-7436
- Grant note
- NO1-HC-35130; HHSN268201100036C / National Heart, Lung, and Blood Institute
- Language
- English
- Date published
- 12/2016
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297446802771
Metrics
10 Record Views