Certain beta blockers (e.g., bisoprolol) may be reevaluated in hypertension guidelines for patients with left ventricular hypertrophy to diminish the ventricular arrhythmic risk

Koraćević, Goran; Stojanović, Milovan; Lović, Dragan; Zdravković, Marija; Sakač, Dejan

doi:10.1038/s41371-021-00505-8

Cited by 9 publications

(11 citation statements)

References 100 publications

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“…ACE inhibitors, ARBs, and CCBs are more effective than BBs and diuretics in bringing about regression in LVH [42, 43]; interestingly, the beneficial effects of RAAS blockers on cardiac and electrophysiological left ventricular remodeling seem to be independent of reduction in BP [44]. On the other hand, there are some inter-class differences between diuretics in the magnitude of reversal of HTN LVH [45]; some BBs can diminish the risk of ventricular arrhythmia in patients with LVH [46]. Mineralocorticosteroid receptor antagonists, although not first-line antihypertensive drugs, have a similar beneficial effect on LVH as ACE inhibitors [47].…”

Section: Resultsmentioning

confidence: 99%

A Discrepancy: Calcium Channel Blockers Are Effective for the Treatment of Hypertensive Left Ventricular Hypertrophy but Not as Effective for Prevention of Heart Failure

et al. 2022

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Objective. Arterial hypertension (HTN) is important due to its high prevalence, morbidity, and mortality rates. Calcium channel blockers (CCBs) are the first-line antihypertensive drugs. HTN can lead to heart failure (HF) by causing hypertensive left ventricular hypertrophy (HTN LVH). CCBs are recommended for the treatment of HTN LVH. The aim of the paper is to analyze the status of CCBs regarding 1) HTN LVH treatment and 2) capability to prevent HTN-induced HF in the guidelines. Methods. A narrative review is used for this paper. A search of the following databases was conducted: Medline, Scopus, Science Direct, Springer, SAGE, Wiley, Oxford Journals, Cambridge, and Google Scholar. Results. CCBs are effective antihypertensive drugs. CCBs are also a very good therapeutic option for HTN LVH because they are capable of causing reverse LVH remodeling. Consequently, we may expect that CCBs would prevent HF. However, evidence suggests CCBs confer less protection from HF than other first-line antihypertensive drugs. A negative inotropic action of non-dihydropyridine CCBs may contribute to suboptimal protection against HF. This discrepancy is clinically relevant because CCBs are in one of the two recommended (single-pill) combinations for the initial treatment of the HTN population. HTN LVH precipitates HF. Conclusion. CCBs are somewhat inferior to renin-angiotensin-aldosterone system blockers but still very good in HTN LVH regression; consequently, CCBs are expected to protect from HF. On the contrary, CCBs protect from HF less than other first-line antihypertensive drugs. This discrepancy needs a clear explanation in order to improve clinical practice.

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Section: Resultsmentioning

confidence: 99%

A Discrepancy: Calcium Channel Blockers Are Effective for the Treatment of Hypertensive Left Ventricular Hypertrophy but Not as Effective for Prevention of Heart Failure

et al. 2022

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“…Current recommendations for treating hypertensive LVH include ACE inhibitors, RAS and CCBs [2,3]. As of right now, ACE inhibitors present themselves as the most potent treatment for LVH [3].…”

Section: Why Treatments Have Failedmentioning

confidence: 99%

“…A three-fold increase in the occurrence of Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF) is observed in patients with hypertensive LVH [2]. Current recommendations for treating hypertensive LVH include ACE inhibitors, RAS and CCBs [2,3]. Despite numerous drug therapies for ventricular hypertrophy, patients often deteriorate.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2023

J Reg Med Biol Res.

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Left Ventricular Hypertrophy is a multifactorial condition involving genetic and signaling pathways. Current recommendations for treating hypertensive LVH include ACE inhibitors, RAS and CCBs. Despite numerous drug therapies for ventricular hypertrophy, patients often deteriorate and experience a decline in ventricular function ultimately leading to heart failure. For this reason, alternative therapies must be investigated. Stem cells possess the potential to divide at a high capacity, self-renew and differentiate into numerous cardiac cell lineages. Furthermore, stem cells are connected to ventricular remodeling and are vital in maintaining the homeostasis of the heart. Further examination of the role of stem cells in LVH could result in the development of targeted therapeutic interventions for prevention or reversal of the phenomenon.

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“…Гіпертонічна ГЛШ пов'язана з майже триразовим збільшенням ризику шлуночкової тахікардії/фібриляції шлуночків. Крім того, гіпертонічна ГЛШ підвищує ризик раптової серцевої смерті [26].…”

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“…Блокатори кальцієвих каналів дещо поступаються блокаторам РААС, але також досить ефективні щодо регресії ЛШ у хворих на АГ [36,37]. У переважній більшості рекомендацій з артеріальної гіпертензії рекомендуються блокатори РААС та блокатори кальцієвих каналів при АГ з метою регресу ГЛШ [38]. Комбіноване лікування блокаторами РААС та дигідропіридиновими БКК відіграє провідну роль у зниженні маси міокарда лівого шлуночка у пацієнтів з АГ [39].…”

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Remodeling and regression of left ventricular hypertrophy in patients with arterial hypertension (literature review)

Biletskyi,

Sydorchuk,

Kazantseva

et al. 2023

Buk. Med. Herald

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The article contains literature information concerning the pathogenesis of hypertrophy and remodeling of the left ventricle (LV) of the heart in patients with arterial hypertension (AH), regression of left ventricular hypertrophy (LVH) under the influence of anti-hypertensive treatment. Remodeling of the heart is its structural geometrical changes occurring under the influence of pathological factors: increasing the number of sarcomeres, length and thickness of cardiomyocytes, increasing or decreasing the wall thickness, and enlargement of the ventricular cavity. The renin-angiotensin-aldosterone system (RAAS) plays a central role in the pathogenesis of hypertrophy and remodeling of the myocardium with AH and heart failure. LVH is one of the most significant predictors of cardiovascular events, including myocardial infarction, stroke, life-threatening ventricular arrhythmias, mortality from cardiovascular diseases, and general mortality. Treatment with angiotensin-converting enzyme inhibitors (ACEI), dihydropyridine calcium channel blockers (CCB), АТ ІІ receptor blockers (ARB) promotes reverse development of LVH and regression of the processes of the heart muscle remodeling. ACEIs are found to be more effective in achieving regression of LVH in patients with AH compared to CCB and beta-blockers. An early beginning of anti-hypertensive therapy and attention to metabolic aspects are critically important to avoid irreversible LVH. The ESH/ESC recommendations (2018) indicate that ACEI and ARB are effective for the prevention or regression of LVH in patients with AH, and beta-blockers are less effective than RAAS blockers and CCB.Objective: to systematize literature data about the pathogenesis of the left ventricle remodeling in patients with arterial hypertension, and the role of anti-hypertensive therapy in the regression of left ventricular hypertrophy. Conclusion. Today, the concept about the role of the renin-angiotensin-aldosterone system in the pathogenesis of hypertrophy and remodeling of the left ventricle in patients with arterial hypertension has been formulated. Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are the most effective in the prevention or regression of left ventricular hypertrophy in patients with arterial hypertension.

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Certain beta blockers (e.g., bisoprolol) may be reevaluated in hypertension guidelines for patients with left ventricular hypertrophy to diminish the ventricular arrhythmic risk

Cited by 9 publications

References 100 publications

A Discrepancy: Calcium Channel Blockers Are Effective for the Treatment of Hypertensive Left Ventricular Hypertrophy but Not as Effective for Prevention of Heart Failure

A Discrepancy: Calcium Channel Blockers Are Effective for the Treatment of Hypertensive Left Ventricular Hypertrophy but Not as Effective for Prevention of Heart Failure

Untitled

Remodeling and regression of left ventricular hypertrophy in patients with arterial hypertension (literature review)

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