Left ventricular hypertrophy. Prevalence in older patients and management
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1Centro di Patologia Cardiovascolare e dell' Ipertensione Arteriosa, Italian National Research Centre on Aging, Ancona.
Insights
Left ventricular hypertrophy (LVH) is common in older adults and can be reversed with certain blood pressure medications. Regression of LVH may offer prognostic benefits, especially in hypertensive patients.
Area of Science:
- Cardiology
- Gerontology
Background:
- Left ventricular hypertrophy (LVH) is a significant cardiovascular condition, increasing with age and contributing independently to morbidity and mortality.
- While echocardiography offers higher sensitivity for LVH detection than electrocardiography, its prevalence is linked more to underlying diseases than aging itself.
Purpose of the Study:
- To investigate the potential for reducing left ventricular (LV) mass through pharmacological interventions.
- To explore whether LVH regression offers prognostic benefits, particularly in elderly populations.
Main Methods:
- Review of existing studies on pharmacological and non-pharmacological approaches to reduce LV mass.
- Analysis of data regarding LVH regression in hypertensive patients, considering the independence of this effect from blood pressure reduction.
Main Results:
- LVH regression is achievable in both young and old hypertensive patients using specific hypotensive drugs.
- The impact of these drugs on LV mass appears largely independent of their blood pressure-lowering effects.
- Preliminary evidence suggests prognostic benefits from LVH regression, though data in the elderly are limited.
Conclusions:
- LVH is a prevalent and serious finding in the elderly, particularly in hypertension.
- Drug therapy can reverse LVH in hypertensive individuals, potentially improving function.
- Further research is required to ascertain the long-term consequences of LV mass reduction in the elderly.
Abstract:
Left ventricular hypertrophy (LVH) can be detected by electrocardiography or, with greater sensitivity, by echocardiography. Its prevalence increases with age, probably due to greater disease diffusion rather than aging itself. LVH is not only a consequence of disease, but also an independent contributor to morbidity and mortality, both in young and aged populations. Attempts have been made to reduce left ventricular (LV) mass by pharmacological and other means. LVH regression is possible in young and old hypertensive patients by some but not all hypotensive drugs. The effect on LV mass seems largely independent of blood pressure reduction. Whether LV mass control should be sought beyond the treatment of the underlying disease is still debated. Preliminary data indicate prognostic benefits associated with LVH regression, but studies on the elderly are scanty. LVH is a common and ominous finding in old people. In hypertension it can be reversed by drug therapy, with apparent functional improvement. Further studies are needed to verify the long term consequence of LV mass reduction in this age group.