Thirty-nine trials with 84 treatment arms were included.
Left ventricular mass index was reduced significantly in the treatment arms, compared with placebo arms (p<0.04).
Left ventricular mass index decreased overall by 10% from its pre-treatment value; the greater the pre-treatment left ventricular mass index, the more marked was the decline in left ventricular mass index associated with antihypertensive drug therapy (r=0.48, p<0.001).
After adjustment for differences in durations of treatment, left ventricular mass decreased 13% (95% confidence interval, CI: 9.9, 16.8) with ACE inhibitors, 9% (95% CI: 5.5, 13.1) with calcium-channel blockers, 6% (95% CI: 2.3, 8.6) with beta-blockers and by 7% (95% CI: 3.0, 10.7) with diuretics (p<0.01). ACE inhibitors reduced left ventricular mass more than beta-blockers (p<0.05) and diuretics (non significant). Similar differences were found between drug classes with regard to effect on left ventricular wall thickness (p<0.05).