[Left ventricular hypertrophy: pathogenesis, diagnosis and therapy]

The life expectancy of hypertonic patients is basically determined by the complications of their disease. The increasing hypertension induces compensated processes in cardiovascular system, however, these alterations further worsen the mortality rates. It is evident that left ventricular hypertrophy (LVH) should be prevented. If it is the case, it has to be moderated among the possible circumstances. To regression of LVH produced by hypertony the decrease of hypertension is not enough, while the process is rather complex. Because the structural changes in the interstitial tissue followed by the alterations of heart myocytes hypertrophy, hyperplasy and apoptosis of myocytes, as well as the interstitial and perivascular fibrosis, coronary remodelling and necrosis in the consequence of insufficient blood circulation can be widely observed. The individual prognosis of LVH can be determined by echocardiography, while the concentric remodelling the development of excentric and concentric hypertrophy is strictly parallel with the increase in the mortality and morbidity rates. According to the evidences the treatment consists of life mode controlling and suitable drug therapy. First line medicines are the ACE-inhibitors and indapamides, later on these drugs can be further combined with calcium antagonists and beta-blockers, if necessary.