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document
Left ventricular mass regression in elderly hypertensives . It is now recognized that left ventricular hypertrophy ( LVH ) , often associated with hypertension , is itself a risk factor for coronary disease in the elderly . Although many agents are capable of controlling blood pressure , the ability of these agents to induce regression of left ventricular ( LV ) mass , and the effect of regression on diastolic relaxation and contractile indices in the elderly are less well known . Our study compared the ability of the calcium blocker , verapamil , and the beta-blocker , atenolol , to both control blood pressure ( BP ) and to induce regression of LV mass in older hypertensives . In addition , the influence of regression on resting diastolic filling and on cardiac output and ejection fraction during rest and mild upright bicycle exercise were determined . Forty-two hypertensives 60 years of age or above , without evidence of ischemic disease underwent 2-D echocardiographic evaluation of LV mass and gated blood pool scan determination of early diastolic filling , cardiac output and ejection fraction . They were then randomized to receive verapamil or atenolol during a four-week titration period so as to achieve a BP of less than 160/90 mm Hg . If BP was not controlled with either agent , chlorthalidone was added . Individuals whose BP was controlled continued on the protocol for six months . At that time , the echocardiographic and gated blood pool studies were repeated both on and after subsequent withdrawal of the study medications . Twenty-one patients were randomized to receive verapamil and 21 patients to receive atenolol . Blood pressure control was achieved with verapamil alone in 18 patients , but with atenolol alone in only 8 patients ( p < 0.01 ) . ( ABSTRACT TRUNCATED AT 250 WORDS )
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Intervention_Pharmacological
calcium blocker , verapamil
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Intervention_Pharmacological
beta-blocker , atenolol
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Intervention_Physical
2-D echocardiographic evaluation
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Intervention_Pharmacological
verapamil
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Intervention_Pharmacological
atenolol
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Intervention_Pharmacological
verapamil
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Intervention_Pharmacological
atenolol
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Outcome_Physical
blood pressure ( BP )
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Outcome_Physical
regression of LV mass
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Outcome_Physical
BP
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Outcome_Physical
BP
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Outcome_Physical
BP
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Participant_Age
elderly
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Participant_Condition
hypertensives
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Participant_Sample-size
Forty-two
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Participant_Condition
hypertensives
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Participant_Age
60 years of age or above
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Participant_Condition
without evidence of ischemic disease