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Left ventricular hypertrophy: a potent cardiovascular risk factor and its relationship to office and ambulatory blood
1University of Connecticut School of Medicine, Farmington, CT 06030-3940, USA. mansoor@nso1.uchc.edu
Insights
Left ventricular hypertrophy (LVH) is a significant cardiovascular risk factor. Controlling blood pressure, especially ambulatory pressure, is key to reducing LVH and associated cardiovascular events.
Area of Science:
- Cardiology
- Hypertension Research
Background:
- Left ventricular hypertrophy (LVH) is a critical cardiovascular risk factor, independent of hypertension.
- Non-invasive detection of LVH is possible through electrocardiography and echocardiography.
Purpose of the Study:
- To highlight the significance of LVH as a cardiovascular risk factor.
- To emphasize the stronger correlation between ambulatory blood pressure and left ventricular mass.
Main Methods:
- Analysis of clinical studies correlating blood pressure measurements (ambulatory vs. office) with left ventricular mass.
- Review of therapeutic interventions aimed at reducing left ventricular mass and their impact on blood pressure.
Main Results:
- Ambulatory blood pressure is a stronger correlate of left ventricular mass than office blood pressure.
- Reductions in left ventricular mass index are more closely linked to decreases in ambulatory blood pressure.
- Therapeutic regression of left ventricular mass may reduce cardiovascular risk.
Conclusions:
- LVH is a serious negative cardiovascular risk factor, more strongly associated with ambulatory blood pressure.
- Optimal antihypertensive therapy leading to hypertrophy regression can reduce short-term cardiovascular events.
- Increased physician awareness of LVH as a cardiovascular risk factor is crucial.
Abstract:
Left ventricular hypertrophy (LVH) is an important cardiovascular risk factor. The presence of LVH carries risk independent of hypertension. LVH can be detected non-invasively using electrocardiography or echocardiography. Clinical studies have consistently shown that ambulatory blood pressure is a stronger correlate of left ventricular mass than office blood pressure. Furthermore, treatment-induced decreases in left ventricular mass index are also more tightly related to reductions in ambulatory blood pressure than reductions in office blood pressure. The primary intervention for subjects with hypertension and LVH is optimal blood pressure control. Several small studies now suggest that therapeutic changes resulting in regression of left ventricular mass also confer a reduction in cardiovascular risk. Therefore, LVH is a serious negative risk factor that is more closely related ambulatory rather than office blood pressure. Fortunately, current evidence suggests that optimal antihypertensive therapy resulting in regression of hypertrophy will reduce at least short-term cardiovascular events. Physicians need to be more aware of LVH as a cardiovascular risk factor.