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[Regression of left ventricular hypertrophy in essential arterial hypertension]
1Universidad de Chile, Hospital San Borja-Arriarán, Santiago de Chile.
Insights
High blood pressure may not solely cause left ventricular hypertrophy. Other factors like genetic and tissue mechanisms are likely involved in this heart condition.
Area of Science:
- Cardiology
- Hypertension Research
- Molecular Cardiology
Background:
- The direct link between hypertension and left ventricular hypertrophy (LVH) is debated.
- Observations show modest correlations and LVH reversal with certain medications.
Purpose of the Study:
- To review mechanisms underlying left ventricular hypertrophy development.
- To challenge the sole responsibility of blood pressure in LVH pathogenesis.
Main Methods:
- Review of existing literature on LVH.
- Analysis of factors including sympathetic nervous system, renin-angiotensin system, genetics, and endothelial function.
Main Results:
- Blood pressure may not be the primary cause of LVH.
- LVH development might be an epiphenomenon of local/tissue mechanisms.
Conclusions:
- Blood pressure is not the sole determinant of left ventricular hypertrophy.
- Genetic factors and local tissue mechanisms play significant roles in LVH.
Abstract:
The classic concept of a direct pathogenic relationship between high blood pressure and development of left ventricular hypertrophy has been challenged by observations such as the modest correlations between blood pressure and magnitude of left ventricular hypertrophy, its frequent reversal with some antihypertensive medications and its experimental prevention with low doses of an angiotensin-converting enzyme inhibitor that do not modify blood pressure. This evidence has prompted the revision of mechanisms or factors involved in the development of left ventricular hypertrophy. The roles of sympathetic nervous and renin-angiotensin systems, genetic and endothelial factors, are reviewed in this article. It is concluded that blood pressure is not the sole responsible for left ventricular hypertrophy, but an epiphenomenon of one or more local or tissular mechanisms, primary or unchained by an unknown genetic factor.