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Ventricular hypertrophy and hypertension: prognostic elements and implications for management

Daniel G Krauser1, Richard B Devereux

  • 1New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA.

Herz
|July 1, 2006
PubMed

Insights

Left ventricular hypertrophy (LVH) predicts cardiovascular events. Treatments targeting Angiotensin II, like ARBs, may reverse LVH and improve outcomes, warranting further study for first-line therapy consideration.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Internal Medicine

Background:

  • Left ventricular hypertrophy (LVH) is a significant independent predictor of adverse cardiovascular outcomes, including stroke, coronary heart disease, and sudden cardiac death.
  • Hypertension is a primary driver for the development of LVH, contributing to its multifactorial prognostic power.
  • LVH signifies both the cumulative effects of risk factors and intrinsic pathological cardiac changes.

Purpose of the Study:

  • To review the role of Angiotensin II in the pathogenesis of LVH.
  • To evaluate the efficacy of antihypertensive treatments, particularly Angiotensin II Receptor Blockers (ARBs), in reversing LVH.
  • To assess the impact of these treatments on cardiovascular outcomes independent of blood pressure reduction.

Main Methods:

  • Review of existing literature on LVH, hypertension, and cardiovascular outcomes.
  • Analysis of studies investigating the effects of specific antihypertensive agents on cardiac structure and function.
  • Evaluation of clinical trial data on ARBs and their impact on LVH and cardiovascular events.

Main Results:

  • Angiotensin II is identified as a key mediator in the development of LVH.
  • Certain antihypertensive therapies, notably ARBs, demonstrate the ability to reverse LVH.
  • These beneficial effects on LVH and cardiovascular outcomes are observed independently of significant blood pressure reduction.

Conclusions:

  • LVH is a critical risk factor for cardiovascular morbidity and mortality.
  • Targeting the renin-angiotensin system, especially with ARBs, offers a promising therapeutic strategy for LVH.
  • Further research is needed to establish ARBs as a first-line treatment for hypertensive patients with LVH.

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