Intensive blood pressure lowering has substantial benefits for both the prevention and treatment of malignant left ventricular hypertrophy , a new analysis of the SPRINT trial shows.
, is a common complication of hypertension and has strong associations with incident heart failure and death. Recent observational data demonstrate that different LVH phenotypes exist, with markedly different risks for heart failure and death. In the current study, the authors aimed to address these questions by analyzing data from the landmark, which compared a strategy of intensive blood pressure lowering with a strategy of standard blood pressure lowering in 9361 patients with hypertension and at high risk for cardiovascular disease.
Results showed that randomization to intensive vs standard blood pressure lowering was associated with a similar relative risk reduction for heart failure or death across all LVH categories. However, because of the much higher event rate in the malignant LVH group, these patients had a greater 4-year absolute risk reduction — 4.4%, compared with 2% in patients with LVH without raised biomarkers and 1.2% in patients without LVH or raised biomarkers.
Among patients without LVH at baseline, intensive blood pressure lowering reduced the risk of developing incident LVH, and in those with LVH without raised biomarkers at baseline, intensive blood pressure was associated with LVH regression.
"Our take-home message is that intensive blood pressure lowering is particularly important in this high-risk group of patients with malignant LVH as a primary prevention strategy to reduce heart failure risk," Ascher commented.
A very important study!