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Regression of LVH occurs to a lesser extent in women treated with antihypertensive medication than in men, a study suggest.

Regression of left ventricular hypertrophy (LVH) occurs to a lesser extent in women treated with antihypertensive medication than in men, according to findings reported in the July issue of Hypertension.

The authors note that the Losartan Intervention For Endpoint reduction in hypertension (LIFE) Study established that treatment with the angiotensin II receptor antagonist losartan or the beta blocker atenolol reduces ECG signs of LVH. Dr. Peter M. Okin, at Weill Cornell Medical College in New York, and colleagues conducted a posthoc analysis of the data to examine potential gender differences in LVH in response to blood pressure normalization.

The study included 4230 men and 4963 women 55 to 80 years of age, with moderate to severe hypertension and with evidence of LVH on ECG. They were followed for a mean of 4.8 years.

"Reductions in ECG LVH by both Cornell product and Sokolow-Lyon voltage criteria were significantly smaller in women than in men, with the smaller reductions becoming apparent after only six months of therapy," the investigators report.

Gender differences in the reduction of LVH by both measures became progressively greater over the course of follow-up (p < 0.001 for both), the authors observed, and changes in echocardiographic LV mass paralleled findings for ECG LVH.

There was also less reduction in the prevalence of ECG LVH among women (p < 0.001).

"These findings suggest that women may derive less prognostic benefit because of their lesser magnitude and lower likelihood of significant LVH regression during antihypertensive therapy," Dr. Okin's group concludes.

In an editorial, Drs. Enrico Agabiti-Rosei and Massimo Salvetti propose that "the observed differences in LVH regression, together with the greater prevalence of LVH, might contribute to the explanation of the steeper increase in the risk of CV events with aging in hypertensive women."

However, the Italian editorialists from the University of Brescia also urge caution in "extrapolating the results observed in this highly selected, high-risk population to hypertensive patients who are encountered in everyday clinical practice."

Hypertension 2008;52:59-60,100-106