Regression of left ventricular hypertrophy with 1 year of antihypertensive treatment in type 1 diabetic patients with early nephropathy.

M-mode echocardiograms were recorded in 22 Type 1 diabetic patients with microalbuminuria (n = 10) or early persistent proteinuria (n = 12). Eight (36%) had both an increased left ventricular mass (males greater than 131 g m-2; females greater than 100 g m-2) and a systolic blood pressure above the 75th centile of the normal blood pressure distribution. These eight patients were treated with antihypertensive drugs, predominantly enalapril, for 1 year. Echocardiograms were repeated after 3 and 12 months. Systolic blood pressure at recruitment was 155 +/- 14 (+/- SD) mmHg, and was significantly lower after 3 months (146 +/- 12 mmHg; p less than 0.05) and 12 months (139 +/- 8 mmHg; p less than 0.005). Diastolic blood pressure did not change significantly. Both intraventricular septal width and left ventricular posterior wall thickness fell progressively and were significantly lower after 12 months treatment (15.0 +/- 2.7 vs 13.0 +/- 2.6 mm, and 10.3 +/- 1.9 vs 8.8 +/- 1.3 mm; both p less than 0.05). Left ventricular mass index was 148 +/- 29 g m-2 at recruitment, but lower after 3 months (131 +/- 25 g m-2; p less than 0.05) and 12 months (132 +/- 26 g m-2; p less than 0.005) antihypertensive therapy.