Ramipril reverses left ventricular hypertrophy
The angiotensin converting enzyme (ACE) inhibitor ramipril
prevents and gradually reverses left ventricular hypertrophy (LVH), according
to results from a sub-study of the Heart Outcomes Prevention Evaluation
(HOPE) trial.
Dr James Mathew, University of Iowa College of Medicine,
Iowa City, and colleagues, randomised patients with or without LVH to
receive either ramipril or placebo. Electrocardiograms were recorded at
the beginning and end of the study. After 4.5 years, the difference in
regression of LVH between the two groups was significant — 46.1 per cent
of patients who had LVH at the start of the study and had received ramipril
had regression of their LVH, compared with 38.6 per cent in the corresponding
placebo group. In addition, the combined outcome of death or development
of LVH was lower in the ramipril group than in the placebo group. Overall,
8.2 per cent of patients who received ramipril developed or had persistent
LVH compared with 9.8 per cent of the placebo group.
The researchers suggest that ramipril might reduce
or prevent LVH by both haemodynamic and neurohormonal mechanisms and comment
that it probably has a direct antihypertrophic effect. The regression
of LVH in patients receiving placebo could be related to risk factor modification
in patients who participate in clinical trials, they say (Circulation
2001;104:1615).
Back to Top
|
