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European Heart Journal 1986 7(3):254-261;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

QRS-amplitudes during antihypertensive treatment: A comparison between beta-blocker and thiazide diuretic regimens

O. SAMUELSSON, G. BERGLUND, D. ELMFELDT, L. WILHELMSEN* and J. WIKSTRAND

Section of Preventive Cardiology, Department of Medicine I, Sahlgrenska and Östra Hospitals, and Department of Clinical Physiology, Sahlgrenska Hospital, University of Göteborg Sweden
*Department of Medicine, Östra Hospital S-416 85 Göteborg, Sweden

Received 30 October 1984; revised 5 November 1985; .

Address for correspondence: Ola Samuelsson, M.D., Hypertension unit, Department of Medicine I, Sahlgrenska Hospital, S-413 45 Göteborg, Sweden

Abstract

QRS-amplitudes and other ECG variables have been studied in 168 middle-aged men with uncomplicated, mild-to-moderate untreated primary hypertension. They were randomized to treatment with either the beta-adrenoceptor blocker metoprolol (n = 88) or the thiazide diuretic hydrochlorothiazide (n = 80). Significant reductions in combinedprecordial voltages (S1 $ R5–6, S2 $ R4, Smax $ Rmax were achieved on both regimens, probably reflecting a regression of hypertensive cardiac involvement. In the group treated with beta-blockers the reduction in all three combined voltage measurements was significant after one year's treatment. A longer period of treatment seemed to be necessary to achieve equal reductions with hydrochlorothiazide although a non-significant reduction was observed after the first year of follow-up in this group. A small increase in 1st degree A V-block was observed on both regimens, but no 2nd degree or total AV-block was recorded.

Key Words: Metoprolol • hydrochlorothiazide • ECG • left ventricular involvement • haemodynamics • hypertension


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