Treatment with the new calcium antagonist isradipine significantly reduced 
diastolic blood pressure to less than 90 mm Hg in 64% of fourteen blacks with 
mild or moderately severe essential hypertension. There was a significant 
reduction in the echocardiographic measures of left ventricular wall thickness 
and mass in these patients. There was also an increase in fractional left 
ventricular mass index, shortening and ejection fraction per 100 g left 
ventricular mass and no indication in mean circumferential shortening. There was 
another indication of improved left ventricular performance. With the reduced 
left ventricular mass and diastolic blood pressure, there was a reduction in the 
ratio of peak systolic wall stress to fractional shortening per 100 g left 
ventricular mass. There was a significant relationship between peak systolic 
wall stress and fractional shortening per 100 g left ventricular mass index. The 
directional change after left ventricular mass reduction with isradipine 
indicated improved left ventricular function. There was an increase in left 
ventricular wall thickness and mass both in those patients not controlled on 
isradipine combined with those treated with placebo (n = 10), and in those 
treated with placebo (n = 5) there was an increase in wall thickness. These 
changes occurred in five weeks. There was no regression to a lower mean of left 
ventricular mass or wall thickness during placebo. There was reduction in 
electrocardiogram (ECG) ST-T changes of ischemia in those patients with 
diastolic blood pressure reduced to less than 90 mm Hg. Isradipine monotherapy 
was an effective antihypertensive drug in blacks with essential hypertension, 
resulting in regression of left ventricular wall thickness and mass and 
augmentation of fractional shortening per 100 g left ventricular mass.