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dc.contributor.authorTapp, Robyn J
dc.contributor.authorSharp, Andrew
dc.contributor.authorStanton, Alice V
dc.contributor.authorO'Brien, Eoin
dc.contributor.authorChaturvedi, Nishi
dc.contributor.authorPoulter, Neil R
dc.contributor.authorSever, Peter S
dc.contributor.authorThom, Simon A McG
dc.contributor.authorHughes, Alun D
dc.contributor.authorMayet, Jamil
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
html.description.abstractWe hypothesized that an amlodipine-based regimen would have more favorable effects on left ventricular (LV) diastolic function.
html.description.abstractDifferent antihypertensive therapies may vary in their effect on LV diastolic function.
html.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.
html.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.
html.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.


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