Cardiac Mass and Aortic Distensibility Following Calcium Blockade in Hypertension

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Abstract
Calcium-entry blockade produced by verapamil was studied in 13 subjects with sustained essential hypertension. Noninvasive echo-Doppler methods were used to evaluate cardiac structure and function, maximum aortic acceleration (used as an indirect index of cardiac performance), and carotid-femoral pulse-wave velocity. Measurements were performed in baseline conditions, following 12 weeks of active treatment, and 4 weeks of placebo. Following verapamil, blood pressure (BP) significantly decreased (p less than 0.001) with a slight reduction in cardiac output (p less than 0.05) and a more substantial decrease in heart rate (p less than 0.002). No significant change occurred in maximum acceleration and in the curve relating percent fractional shortening to end-systolic stress, suggesting that verapamil decreased BP with minor changes in cardiac performance. Cardiac mass decreased by approximately 6.3% whereas pulse-wave velocity did not change, suggesting that the small decrease in cardiac mass could be related to the lack of improvement in the capacitative component of vascular impedance, as judged from the determination of pulse-wave velocity. The study provides evidence that calcium blockade due to verapamil results in a dissociation between the antihypertensive effect and the absence of significant changes in cardiac and arterial structure and function.

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