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Related Experiment Videos

The heart in the hypertensive elderly

T Grodzicki1, F H Messerli

  • 1Department of Gerontology and Family Medicine, Cracow, Poland.

Journal of Human Hypertension
|October 23, 1998
PubMed
Summary

Left ventricular hypertrophy (LVH) increases cardiovascular risk in the elderly. Reducing LV mass through treatment, particularly with ACE inhibitors, can improve heart function and prognosis.

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Area of Science:

  • Cardiology
  • Gerontology
  • Pathology

Background:

  • Left ventricular (LV) mass increases with age, particularly in senescence.
  • In normotensive elderly, LVH stems from connective tissue degeneration; in hypertensive patients, it involves muscle and fibrotic tissue increase.
  • LVH affects up to 50% of elderly hypertensive patients and is linked to increased cardiovascular events.

Purpose of the Study:

  • To investigate the implications of LVH in the elderly.
  • To explore the relationship between LVH, aging, and cardiovascular outcomes.
  • To evaluate the potential benefits of LVH regression on cardiac function and prognosis.

Main Methods:

  • The study reviews existing literature on LV mass, LVH, and aging.
  • Echocardiographic criteria are used to define LVH.
  • The impact of LVH on coronary reserve, arrhythmias, and LV function is discussed.

Main Results:

  • LVH is associated with reduced coronary reserve, increased arrhythmias, and worsened LV function, even without coronary stenosis.
  • Increased interstitial fibrosis and collagen cross-linking contribute to myocardial stiffness and diastolic dysfunction in senescent hearts.
  • Regression of LVH improves LV filling, coronary reserve, and reduces arrhythmias.

Conclusions:

  • LVH regression is associated with improved cardiovascular prognosis and should be a therapeutic goal in hypertension management.
  • Angiotensin-converting-enzyme inhibitors show the greatest efficacy in reducing LV mass compared to other antihypertensive agents.

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