Reversal of left ventricular hypertrophy with the ACE inhibitor moexipril in patients with essential hypertension

Abstract

Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for cardiovascular morbidity and mortality and is a common complication of essential hypertension. Therefore, antihypertensive treatment should decrease blood pressure (BP) and potentially reverse LVH. However, antihypertensive drugs may result in different effects on LVH despite similar BP reduction. The aim of this study was to evaluate the effect of the ACE inhibitor Moexipril on LVH in patients with essential hypertension. Methods: This was a multicentre, international single-blind study. After a wash-out placebo-period of 2 weeks, Moexipril 15 mg once daily was administered for 24 weeks followed by a second 2-week placebo period. LVH was assessed by echocardiography [Left Ventricular Mass Indexed for body Surface area (LVMIs)] with a central blind reading by two independent experts. Results: Valid echocardiographic data were available for 72 patients (Full Analysis Set). The results show a significant decrease of LVMIs and blood pressure under Moexipril. The decrease in LVMIs (15.0%) was independent from the regression to the mean phenomenon as shown from the data of the placebo period. Similar results (decrease in LVMIs 16.8%) were obtained for the Completers Set (treatment for 24 ± 1 weeks). Conclusion: Moexipril 15 mg once daily administered for 24 weeks resulted in a clinical significant reversal of LVH in patients with essential hypertension. Moexipril was safe and well tolerated. (See Table) comparison between Moexipril (W24) and placebo (W2) comparison between Moexipril (W24) and placebo (W2)