For hypertension patients, preventing or reducing enlarged heart may decrease risk for diabetes

High-blood-pressure patients treated for enlarged heart (left ventricular hypertrophy, LVH) who have regression or prevention of LVH may also have a better chance of preventing diabetes.

Led by physician-scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, the research is published in the November Hypertension , a journal of the American Heart Association (AHA).

An estimated 20 percent of all high-blood-pressure patients, or 12 million Americans, have LVH and are at increased risk of developing diabetes.

The study reports a 38-percent reduced risk of developing diabetes for high-blood-pressure patients who demonstrated regression of LVH during treatment for high blood pressure, with a 26-percent reduced risk after adjusting for other risk factors for diabetes. The reduction in risk of diabetes was independent of treatment type and of the degree of blood pressure change in this population.

"A healthy heart is a prerequisite for the health of the body as a whole. Our previous research has shown that treating enlarged heart in high-blood-pressure patients reduces the risk for a variety of cardiovascular conditions. This new study finds an important new benefit -- namely a better chance of avoiding diabetes among patients who exhibit a reduction of their hypertrophy during treatment," says the study's principal investigator, Dr. Peter Okin, director of clinical affairs and professor of medicine in the Greenberg Division of Cardiology at Weill Cornell Medical College and attending physician at NewYork-Presbyterian/Weill Cornell.

An editorial about the study in the journal notes that "the study by Okin et al extends our knowledge and understanding of the importance of LVH reversal by showing the beneficial metabolic effects of treatment-induced regression of LVH in a large series of patients with hypertensive heart disease."

Unfortunately, for high-blood-pressure patients who already have diabetes, high blood pressure treatment is less effective at reducing their LVH compared to patients without diabetes. In addition, regression of LVH in hypertensive patients with diabetes does not appear to be associated with a reduction in cardiovascular events, according to a 2006 study by Dr. Okin and colleagues, making prevention of diabetes in patients with hypertension an important goal.

The study used data from the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) study conducted between 1995 and 2001. In the blinded study, patients received daily 50 mg doses of either losartan or atenolol.

Co-authors of the current study included Drs. Richard B. Devereux of NewYork-Presbyterian/Weill Cornell and Weill Cornell Medical College, and physician-scientists from Merck Research Laboratories (Upper Gwynedd, Pa.), Sahlgrenska University Hospital/Östra (Sweden), Ullevål University Hospital (Norway) and Umeå University (Sweden).

The study was supported in part by a grant from Merck & Co. Inc., West Point, Pa.

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