Hypertension Drug May Help Reduce Heart Ailments - A drug used to treat high blood pressure also may be effective in reversing heart enlargements, lowering a person's risk of developing long-term cardiovascular complications, researchers said. Scientists at the University of Iowa found that 91.9 percent of patients given a drug called Ramipril either failed to show conditions of an enlarged heart, known as left ventricular hypertrophy (LVH), or experienced a reduction in heart size.
The level of regression in LVH patients given Ramipril was 46 percent compared to 38.6 percent in a group of patients given a placebo. Dr. James Mathew, lead author of the study, and his team examined the electrocardiograms of 8,281 patients who had a vascular disease or diabetes with at least one additional risk factor such as hypertension or high cholesterol. Patients were given 10 milligrams of Ramipril each day during the 4-1/2-year study.
Ramipril, marketed under the name Altace by Bristol, Tennessee-based King Pharmaceuticals Inc., is an ACE inhibitor. These drugs expand blood vessels and decrease the workload of the heart. Previous studies have shown that when the heart's main pumping chamber becomes enlarged because of a condition such as high blood pressure, the chances for stroke, heart attacks or congestive failure increase because the cardiovascular muscles thicken and are forced to work harder.
"There is compelling evidence to provide ACE inhibitors to persons at high risk for cardiovascular disease, especially left ventricular hypertrophy based on the findings of this study," Mathew said.
Mathew believes an ECG, because it is easily applied and relatively inexpensive, could be included as part of a routine evaluation for patients at high risk of developing LVH.
"Because we are using ECG to identify LVH, it can be easily applied to large populations," Mathew said. "We think we can now reduce the risk of cardiovascular events and death."
Before the study, researchers had focused on preventing the development or causing the regression of abnormal muscle growth in the heart by using high blood pressure medication. Mathew found that Ramipril causes the regression of LVH even if high blood pressure was not evident in the patient.
The risk of stroke, heart attacks or cardiovascular failure in patients who did not develop LVH or experienced regression was 12.3 percent, while the rate among those who developed LVH or did not show regression was 15.8 percent. Heart failure was 9.3 percent in patients with regression or prevention, and 15.4 percent in the LVH group.
Writing in the journal Circulation, published by the American Heart Association, Mathew said he was surprised to find that 90 percent of the patients given the placebo experienced prevention or regression. Patients may have received more medical attention, he said, and were more likely to make changes in their lifestyle that improved their health.