Modulation of the QT interval duration in hypertension with antihypertensive treatment

Abstract

The duration of the QT interval as measured by 12-lead electrocardiography is a measure of myocardial repolarization and is widely used to describe cardiac abnormalities, to determine the presence of cardiac toxicity and to evaluate drug safety. In hypertension, the QT interval is a predictor of the risk of both coronary events and cardiovascular death, after adjusting for the effects of additional risk factors. The mechanism of QT interval prolongation is multifactorial and includes cardiomyocyte hypertrophy and increased left ventricular mass, with accompanying changes in left ventricular transmural dispersion of repolarization, as well as changes in the tone of the autonomic nervous system of some patients with hypertension and mechano-electrical feedback, although this mechanism is less likely. Antihypertensive drugs vary in their effect on QT interval duration. The mechanisms underlying their effect depend on changes in left ventricular mass and autonomic nervous system tone, as well as changes in the activity of cardiac ion channels. Although blood pressure reduction is the primary goal of antihypertensive drug therapy and although the choice of antihypertensive drug treatment regimens varies among different individuals, the data regarding the disparate effects of antihypertensive drugs on the duration of the QT interval warrant consideration when implementing long-term pharmacotherapy for hypertension.

Effect of sodium‐glucose co‐transporter‐2 inhibitors on impaired ventricular repolarization in people with Type 2 diabetes

“…Thus, QTc dispersion prolongation is often observed in people with hypertension and obesity. Previous studies showed that blood pressure control and weight loss were effective for improving ventricular repolarization abnormality [10,11]. In the present study, treatment with an SGLT2 inhibitor significantly reduced systolic blood pressure and body weight.…”

“…Previous studies showed that blood pressure control and weight loss were effective for improving ventricular repolarization abnormality [10,11]. Previous studies showed that blood pressure control and weight loss were effective for improving ventricular repolarization abnormality [10,11].…”

“…By contrast to the conventional agents, SGLT2 inhibitors have pleiotropic effects including blood pressure reduction and Correspondence to: Takayuki Miki. Because reductions in blood pressure and body weight have been reported to improve ventricular repolarization abnormality [10,11], we hypothesized that treatment with an SGLT2 inhibitor would reverse ventricular repolarization heterogeneity in people with Type 2 diabetes. Because reductions in blood pressure and body weight have been reported to improve ventricular repolarization abnormality [10,11], we hypothesized that treatment with an SGLT2 inhibitor would reverse ventricular repolarization heterogeneity in people with Type 2 diabetes.…”

“…E-mail: tmiki@sapmed.ac.jp ª 2017 Diabetes UK body weight loss [2,4]. Because reductions in blood pressure and body weight have been reported to improve ventricular repolarization abnormality [10,11], we hypothesized that treatment with an SGLT2 inhibitor would reverse ventricular repolarization heterogeneity in people with Type 2 diabetes.…”

Effects of L- and N-Type Ca Channel Blocker Cilnidipine on Changes in Heart Rate and QT Interval During Dialysis

“…QT interval is a predictor of the risk of both coronary events and cardiovascular death after adjusting for the effects of additional risk factors in hypertension [30, 31]. QT intervals in HD patients are longer than those in the general population, and 65% of these patients show longer QT intervals [32].…”