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Optimal antihypertensive therapy for prevention and treatment of left ventricular hypertrophy

P R Liebson1, R D Serry

  • 1Section of Cardiology, Department of Medicine, Rush Medical College, 1653 West Congress Parkway, Chicago, IL 60612, USA. pliebson@rush.edu

Current Hypertension Reports
|September 12, 2000
PubMed

Insights

Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular events in hypertensive patients. While all first-line agents can regress LVH, their comparative efficacy in reducing cardiovascular risk independently of blood pressure remains unproven.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Internal Medicine

Background:

  • Left ventricular hypertrophy (LVH) is a common adaptation to pressure overload in hypertensive patients.
  • LVH is a significant independent risk factor for cardiovascular events, exceeding the risk associated with blood pressure alone.
  • Current hypertension guidelines recommend stricter blood pressure control in patients with LVH.

Purpose of the Study:

  • To review the current understanding of left ventricular hypertrophy in hypertension.
  • To evaluate the role of antihypertensive agents in regressing LVH.
  • To discuss the implications of LVH regression on cardiovascular prognosis.

Main Methods:

  • Literature review of studies on left ventricular hypertrophy and hypertension.
  • Analysis of evidence regarding the efficacy of first-line antihypertensive agents on LVH regression.
  • Evaluation of prognostic data linking LVH regression to cardiovascular outcomes.

Main Results:

  • All major classes of antihypertensive agents demonstrate some capacity to regress LVH.
  • No definitive evidence currently establishes the superiority of one antihypertensive agent over others in reducing cardiovascular risk independent of blood pressure control.
  • Evidence suggests LVH regression may be associated with improved prognosis, but comparative drug efficacy in this regard is not yet demonstrated.

Conclusions:

  • Optimal antihypertensive therapy for patients with LVH should consider individual patient conditions.
  • Major antihypertensive drug classes are expected to reduce LVH.
  • Further research is needed to determine the relative efficacy of different drug classes in improving prognosis through LVH regression.

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