IMPORTANCE OF INDAPAMIDE ON CONTROL OF BLOOD PRESSURE IN LEFT VENTRICULAR HYPERTROPHY

Left ventricular hypertrophy (LVH) is a consequence of persistent prolonged systemic hypertension. It is initially a compensatory mechanism, but later, left ventricular hypertrophy carries the risk of arrhythmia, congestive heart failure, angina, systolic and diastolic dysfunction, increased severity and risk of myocardial infarction and heart ruptures. The Framingham Heart Study and other studies have shown that LVH is an independent risk factor for cardiovascular morbidity and mortality. Some classes of drugs regress LVH, e.g., ACE inhibitor, AT1 receptor blockers, calcium channel blockers, B blockers, and methyldopa. The effect of diuretics on regression is inconclusive. Aim: To determine the role of indapamide on hypertensive left ventricular hypertrophy. Place and Duration: In the Medicine Unit and Cardiology department of Bahawal Victoria Hospital (BVH) Bahawalpur for one-year duration from March 2019 to March 2020. Methods: We administered indapamide 2.5 mg to 7 patients with echocardiographic evidence of LVH and found that LVID (mm) (mean + SEM) decreased from 50.7+ 1.2 to 50.20 + 1.70, IVST (mean + SEM) decreased from 14.10 + 0.4 to 11.9 + 0.30, PWT (mean + SEM) decreased from 13.0 + 0.3 to 11.2 + 0.2, and LVMI (mean + SEM ) decreased from 176.42 + 6.13 to 145.25 + 6.04 g / m2. Results: All patients achieved normal blood pressure, defined as diastolic blood pressure below 90 mmHg. The maximum effect on hypertension was seen within two weeks of treatment. The posterior wall thickness decreased from 13 ± 0.3 (mm) to 11.2 ± 0.2 mm (p <0.001). The interventricular septum thickness decreased from 14.10 ± 0.4 to 11.9 ± 0.3 mm (P <0.001) and the left ventricular mass index decreased from 176.42 ± 6.13 to 145.25 ± 6.04 g / m2 (P <.0001), a mean reduction of 16%. The left ventricular end-diastolic diameter did not decrease significantly (from 50.7 ± 1.2 to 50.20 ± 170). However, there was a significant relationship between ventricular septum thickness and left ventricular mass index. Key words: indapamide, left ventricular hypertrophy, regression, LVM