Differential effects of antihypertensive treatment on left ventricular diastolic function: an ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) substudy.

Hdl Handle:
http://hdl.handle.net/10147/126568
Title:
Differential effects of antihypertensive treatment on left ventricular diastolic function: an ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) substudy.
Authors:
Tapp, Robyn J; Sharp, Andrew; Stanton, Alice V; O'Brien, Eoin; Chaturvedi, Nishi; Poulter, Neil R; Sever, Peter S; Thom, Simon A McG; Hughes, Alun D; Mayet, Jamil
Affiliation:
International Centre for Circulatory Health, NHLI, St. Mary's Hospital and Imperial College London, St. Mary'sCampus, London, United Kingdom. r.tapp@imperial.ac.uk
Citation:
Differential effects of antihypertensive treatment on left ventricular diastolic function: an ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) substudy. 2010, 55 (17):1875-81 J. Am. Coll. Cardiol.
Journal:
Journal of the American College of Cardiology
Issue Date:
27-Apr-2010
URI:
http://hdl.handle.net/10147/126568
DOI:
10.1016/j.jacc.2009.11.084
PubMed ID:
20413040
Abstract:
We hypothesized that an amlodipine-based regimen would have more favorable effects on left ventricular (LV) diastolic function.; Different antihypertensive therapies may vary in their effect on LV diastolic function.; The HACVD (Hypertension Associated Cardiovascular Disease) substudy of ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) collected detailed cardiovascular phenotypic data on a subset of 1,006 participants recruited from 2 centers (St. Mary's Hospital, London, and Beaumont Hospital, Dublin). Conventional and tissue Doppler echocardiography and measurement of plasma B-type natriuretic peptide (BNP) were performed approximately 1 year after randomization to atenolol-based or amlodipine-based antihypertensive treatment to assess LV diastolic function.; On-treatment blood pressure (BP) (mean +/- SD) was similar in both groups: atenolol-based regimen, systolic BP of 137 +/- 17 mm Hg, diastolic BP of 82 +/- 9 mm Hg; amlodipine-based regimen, systolic BP of 136 +/- 15 mm Hg, diastolic BP of 80 +/- 9 mm Hg. Ejection fraction did not differ between groups, but early diastolic mitral annular velocity (E'), a measure of diastolic relaxation, was lower in patients on the atenolol-based regimen: atenolol-based regimen, 7.9 +/- 1.8; amlodipine-based regimen, 8.8 +/- 2.0. A measure of left ventricular filling pressure, E/E', and BNP were significantly higher in patients on the atenolol-based regimen. Differences in E', E/E', and BNP remained significant after adjustment for age and sex. Further adjustment for systolic BP, LV mass index, and heart rate had no impact on differences in mean E' or BNP. The difference in E/E' was attenuated.; Patients receiving treatment with an amlodipine-based regimen had better diastolic function than patients treated with the atenolol-based regimen. Treatment-related differences in diastolic function were independent of BP reduction and other factors that are known to affect diastolic function.
Item Type:
Article
Language:
en
MeSH:
Amlodipine; Antihypertensive Agents; Atenolol; Blood Pressure; Diastole; Echocardiography, Doppler; Female; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Ventricular Function, Left
ISSN:
1558-3597

Full metadata record

DC FieldValue Language
dc.contributor.authorTapp, Robyn Jen
dc.contributor.authorSharp, Andrewen
dc.contributor.authorStanton, Alice Ven
dc.contributor.authorO'Brien, Eoinen
dc.contributor.authorChaturvedi, Nishien
dc.contributor.authorPoulter, Neil Ren
dc.contributor.authorSever, Peter Sen
dc.contributor.authorThom, Simon A McGen
dc.contributor.authorHughes, Alun Den
dc.contributor.authorMayet, Jamilen
dc.date.accessioned2011-03-31T12:56:25Z-
dc.date.available2011-03-31T12:56:25Z-
dc.date.issued2010-04-27-
dc.identifier.citationDifferential effects of antihypertensive treatment on left ventricular diastolic function: an ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) substudy. 2010, 55 (17):1875-81 J. Am. Coll. Cardiol.en
dc.identifier.issn1558-3597-
dc.identifier.pmid20413040-
dc.identifier.doi10.1016/j.jacc.2009.11.084-
dc.identifier.urihttp://hdl.handle.net/10147/126568-
dc.description.abstractWe hypothesized that an amlodipine-based regimen would have more favorable effects on left ventricular (LV) diastolic function.-
dc.description.abstractDifferent antihypertensive therapies may vary in their effect on LV diastolic function.-
dc.description.abstractThe HACVD (Hypertension Associated Cardiovascular Disease) substudy of ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) collected detailed cardiovascular phenotypic data on a subset of 1,006 participants recruited from 2 centers (St. Mary's Hospital, London, and Beaumont Hospital, Dublin). Conventional and tissue Doppler echocardiography and measurement of plasma B-type natriuretic peptide (BNP) were performed approximately 1 year after randomization to atenolol-based or amlodipine-based antihypertensive treatment to assess LV diastolic function.-
dc.description.abstractOn-treatment blood pressure (BP) (mean +/- SD) was similar in both groups: atenolol-based regimen, systolic BP of 137 +/- 17 mm Hg, diastolic BP of 82 +/- 9 mm Hg; amlodipine-based regimen, systolic BP of 136 +/- 15 mm Hg, diastolic BP of 80 +/- 9 mm Hg. Ejection fraction did not differ between groups, but early diastolic mitral annular velocity (E'), a measure of diastolic relaxation, was lower in patients on the atenolol-based regimen: atenolol-based regimen, 7.9 +/- 1.8; amlodipine-based regimen, 8.8 +/- 2.0. A measure of left ventricular filling pressure, E/E', and BNP were significantly higher in patients on the atenolol-based regimen. Differences in E', E/E', and BNP remained significant after adjustment for age and sex. Further adjustment for systolic BP, LV mass index, and heart rate had no impact on differences in mean E' or BNP. The difference in E/E' was attenuated.-
dc.description.abstractPatients receiving treatment with an amlodipine-based regimen had better diastolic function than patients treated with the atenolol-based regimen. Treatment-related differences in diastolic function were independent of BP reduction and other factors that are known to affect diastolic function.-
dc.language.isoenen
dc.subject.meshAmlodipine-
dc.subject.meshAntihypertensive Agents-
dc.subject.meshAtenolol-
dc.subject.meshBlood Pressure-
dc.subject.meshDiastole-
dc.subject.meshEchocardiography, Doppler-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshNatriuretic Peptide, Brain-
dc.subject.meshVentricular Function, Left-
dc.titleDifferential effects of antihypertensive treatment on left ventricular diastolic function: an ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) substudy.en
dc.typeArticleen
dc.contributor.departmentInternational Centre for Circulatory Health, NHLI, St. Mary's Hospital and Imperial College London, St. Mary'sCampus, London, United Kingdom. r.tapp@imperial.ac.uken
dc.identifier.journalJournal of the American College of Cardiologyen
dc.description.provinceLeinster-

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