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Intensive Blood Pressure Lowering in Malignant Left Ventricular Hypertrophy

In SPRINT (Systolic Blood Pressure Intervention Trial), the absolute risk of acute decompensated heart failure (ADHF) and death was reduced by intensive blood pressure lowering in 8,820 patients with malignant left ventricular hypertrophy (malignant LVH). Electrocardiograms and biomarker levels were used to group participants with or without LVH. After randomization to intensive or standard systolic blood pressure (SBP) lowering, results were assessed based on the rates of acute decompensated heart failure (ADHF) events and death and the incidence and regression of malignant LVH.

The results showed: “Randomization to intensive SBP lowering led to similar relative reductions in ADHF events and death across the combined LVH/biomarker groups (P for interaction = 0.68). The absolute risk reduction over 4 years in ADHF events and death was 4.4% (95% CI: −5.2% to 13.9%) among participants with baseline malignant LVH (n = 449) and 1.2% (95% CI: 0.0%-2.5%) for those without LVH and nonelevated biomarkers (n = 4,361). Intensive SBP lowering also reduced the incidence of malignant LVH over 2 years (2.5% vs 1.1%; OR: 0.44; 95% CI: 0.30-0.63).”

Source: Journal of the American College of Cardiology