Prevalence and natural history of left ventricular hypertrophy in hypertension.
Left ventricular hypertrophy (LVH) is a major complication of hypertension. It is a major risk factor for mortality, including sudden death. Although LVH is not always directly related to the level of blood pressure (BP), it occurs early in the course of hypertension. In the early stages of hypertension, LVH is associated with reduced cardiac function, even in the presence of a well-maintained ejection fraction and cardiac output. Thus, it is important to detect LVH early in the course of hypertension and halt its progression. Prevalence of LVH in the hypertensive population varies, mostly because of the different methods used for its diagnosis. Prevalence of increased left ventricular mass, determined by echocardiography, ranges from 26% to 48% in patients with hypertension. On the other hand, prevalence of tall R wave, ST segment deviation, and T-wave inversion, determined by ECG, is considerably lower than that. In the Hypertension Detection and Follow-Up Program (HDFP), in which all hypertensive participants had a 12-lead ECG at baseline, the prevalence of ECG-determined LVH was between 5% and 11%, depending on criteria used (e.g., tall R wave alone or ST segment deviation). Rigorous treatment of hypertension halts the progression of LVH and may cause regression as well. To be effective, treatment must begin early in the course of hypertension, especially mild hypertension (i.e., diastolic BP (DBP) 90-104 mmHg). It is in the early stages of hypertension that effective treatment will most likely exert its beneficial effect in the prevention of LVH.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D006332:Cardiomegaly / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012306:Risk; D013997:Time Factors