Management of coronary artery disease in patients with hypertensive left ventricular hypertrophy

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Published on: February 11, 2017

F G Dunn

    The American Journal of Medicine
    |September 26, 1983
    PubMed

    Insights

    Managing hypertension and coronary artery disease in patients with left ventricular hypertrophy requires careful drug selection. Beta-blockers and calcium channel blockers are often beneficial for this high-risk group.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Patients with both coronary artery disease and hypertensive left ventricular hypertrophy represent a high-risk group.
    • Optimal management of hypertension and ischemic symptoms is crucial for this population.

    Purpose of the Study:

    • To review the cardiac effects of antihypertensive drugs.
    • To guide rational management strategies for patients with coexisting coronary artery disease and hypertensive left ventricular hypertrophy.

    Main Methods:

    • Review of pharmacologic advances in antihypertensive therapy over the past decade.
    • Analysis of drug properties relevant to cardiac effects and specific patient populations.

    Main Results:

    • Beta-blocking agents are effective for both coronary artery disease and hypertension, provided heart failure is absent.
    • Calcium channel blockers possess both antianginal and antihypertensive properties.
    • Caution is advised with pure arteriolar dilators due to potential adverse reflexive cardiac effects.
    • Monitoring serum potassium is essential when diuretics are used, given the increased risk of dysrhythmias.

    Conclusions:

    • A rational approach to managing patients with coronary artery disease and hypertensive left ventricular hypertrophy involves careful selection of antihypertensive agents.
    • Specific attention to high-risk groups can further improve mortality rates from coronary heart disease.

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