Pathophysiology and clinical aspects of hypertensive hypertrophy

Individuals with hypertension and electrocardiographic (ECG) evidence of left ventricular hypertrophy (LVH) have a 10-fold greater risk of developing cardiac failure than hypertensives without ECG evidence of LVH. LVH in hypertension is characterized by myocardial fibrosis and structural changes to...

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Bibliographic Details
Published in:European heart journal 1993-07, Vol.14 (suppl-D), p.2-7
Main Authors: Vogt, M., Motz, W. H., Schwartzkopf, B., Strauer, B. E.
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Antihypertensive Agents - therapeutic use
Calcium Channel Blockers - therapeutic use
Coronary Circulation - drug effects
Coronary Circulation - physiology
Endomyocardial Fibrosis - drug therapy
Endomyocardial Fibrosis - physiopathology
Hemodynamics - drug effects
Hemodynamics - physiology
Humans
Hypertension - drug therapy
Hypertension - physiopathology
hypertensive disease of small coronary arteries
Hypertrophy, Left Ventricular - drug therapy
Hypertrophy, Left Ventricular - physiopathology
Left ventricular hypertrophy
pathophysiology
Renin-Angiotensin System - drug effects
Renin-Angiotensin System - physiology
treatment
Ventricular Function, Left - drug effects
Ventricular Function, Left - physiology
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Summary:Individuals with hypertension and electrocardiographic (ECG) evidence of left ventricular hypertrophy (LVH) have a 10-fold greater risk of developing cardiac failure than hypertensives without ECG evidence of LVH. LVH in hypertension is characterized by myocardial fibrosis and structural changes to the small intramural arteries. Hypertensives with or without LVH have reduced coronary vasodilator reserve due to hypertensive disease of small coronary arteries. Prognosis of arterial hypertension is largely determined by cardiac complications. The aim of treatment of hypertensive heart disease is to reverse myocardial hypertrophy in order to prevent progression to hypertensive heart failure, as well as reversal of the hypertensive disease of small coronary arteries in order to improve coronary reserve. On the development of hypertensive heart failure, administration of digitalis, diuretics and angiotensin converting enzyme (ACE) inhibitors should be initiated. Although regression of LVH can be induced by dihydropyridine calcium channel blockers. ACE inhibitors and sympatholytic substances, clinical evidence of the reversal of hypertensive disease of small coronary arteries has still to be established.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/14.suppl_D.2