Blood pressure profile as a predictor of reversal of cardiovascular structural changes during antihypertensive treatment

Several studies have demonstrated that antihypertensive treatment can induce the regression of cardiovascular structural changes, but the magnitude of this phenomenon may be different in individual patients, The aim of this study was to demonstrate that the nocturnal fall in blood pressure can predict the extent of the regression in left ventricular mass. We enrolled 18 patients with mild-to-moderate essential arterial hypertension who after a 2-week placebo run-in period underwent baseline evaluation, Subsequently, a 12-lead standard electrocardiogram, echocardiographic study, and 24-hour blood pressure monitoring were performed. The patients received amlodipine 10 mg once a day, and control visits were performed monthly, Ambulatory blood pressure measurements were repeated after 1 month of therapy, whereas safety evaluations, the electrocardiogram, and echocardiographic study were repeated after 5 additional months, During the study there was a significant reduction of systolic and diastolic blood pressure at each visit, Moreover, the 24-hour mean values of systolic, diastolic, and mean arterial pressure significantly decreased after 4 weeks with amlodipine, In particular, we observed a potentiation of the nocturnal fall in mean arterial pressure, and the magnitude of this phenomenon was significantly related to the extent of the regression in left ventricular mass recorded after 6 months of treatment, Our data suggest that, during antihypertensive treatment, the changes in nocturnal fall in blood pressure may be considered reliable predictors of the degree of regression in hypertension-induced cardiovascular structural changes that can be achieved.