Effects of calcium channel blockade on cardiac repercussions of long-standing hypertension.
Left ventricular hypertrophy (LVH) is a common sequela of long-standing hypertension. However, LVH can no longer be considered as an adaptive process serving to normalize wall stress. The occurrence of LVH in a given patient significantly increases the risk of sudden death, myocardial ischemia, congestive heart failure, and other cardiovascular morbidity and mortality. Patients with LVH often exhibit increased ventricular ectopic activity, myocardial ischemia, and diminished ventricular compliance even in the absence of coronary artery disease. LVH has been shown to regress in parallel with arterial pressure when specific antihypertensive agents are given. Recent evidence indicates that calcium channel blockers cannot only lower pressure and reduce LVH but will suppress ectopic impulse generation, improve ventricular compliance, and alleviate myocardial ischemia in susceptible patients as well. However, whether such a promising therapeutic approach will ultimately diminish the risk of the well-documented increased cardiovascular morbidity and mortality associated with LVH remains to be documented.
Messerli
F H
FH
Department of Internal Medicine, Ochsner Clinic, New Orleans, LA 70121.
D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D006331:Heart Diseases / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*
D002121:Calcium Channel Blockers