Sept. 17, 2008

High blood pressure treatment could put women at greater risk than men for enlarged heart

New research shows that women benefit less than men from two common blood pressure drugs -- losartan and atenolol -- for the reduction of left-ventricular hypertrophy (LVH). The condition is a thickening and enlargement of muscle of the left ventricle of the heart and a marker for future heart disease.

The observations were made despite results showing that blood pressure reduction was similar between genders.

The findings, published with an accompanying editorial in a recent issue of Hypertension, the journal of the American Heart Association, could explain why women are at greater risk for heart disease later in life.

Cardiovascular disease is the leading cause of death in Western countries in both sexes. However, women have a greater chance of dying from their first heart attack and from stroke, and they tend to have more cardiovascular problems later in life compared with men.

The research, a five-year follow-up to a study called the Losartan Intervention For Endpoint reduction in hypertension (LIFE), showed that men and women had similar outcomes in lowering their blood pressure while taking losartan or atenolol. However, the degree in reduction in LVH was significantly greater in men than women in the study.

The original study examined blood pressure but did not look at how LVH differed between men and women taking the drugs.

"LVH is a very serious condition. When the heart's muscle is thicker than it should be, the heart has to work harder," said cardiologist Peter M. Okin, the study's lead author and a professor of medicine at WCMC. Symptoms of LVH include shortness of breath, chest pain, dizziness, irregular heartbeat and fainting.

"But there may no be signs or symptoms of LVH for many years, or never at all, making screening with electrocardiography essential," Okin said.

The researchers studied electrocardiograms of 9,193 people in the LIFE study. They found that over the five-year period, the difference of LVH reduction between men and women significantly widened, even though hypertension continued to fall in both groups.

The research team controlled for age, race, body mass index, diabetes and smoking; and for various known causes of heart disease, including high cholesterol.