Objectives of high blood pressure treatment: left ventricular hypertrophy, diastolic function, and coronary reserve.
The prehypertrophic state of hypertensive heart disease is characterized by morphologic changes (interstitial fibrosis, increase in intramyocardial arteriolar wall thickness) as well as by functional alterations (diastolic dysfunction, decrease in coronary reserve). These changes most probably represent the earliest cardiac end-organ lesions that can clinically be detected. In cardiac hypertrophy, long-term (9-12 months) pharmacotherapy with beta-blockers, calcium channel blockers, or ACE inhibitors reverses left ventricular hypertrophy by 8% to 14%, whereas marked improvement in coronary reserve and diastolic dysfunction is achieved by calcium blocker and preferably by ACE inhibitors.
Strauer
B E
BE
Department of Medicine, University of Düsseldorf, Germany.
Schwartzkopff
B
B
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001160:Arterioles / Q000187:drug effects / Q000473:pathology; D017298:Bisoprolol / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D004110:Diltiazem / Q000627:therapeutic use; D018450:Disease Progression; D004656:Enalapril / Q000627:therapeutic use; D005355:Fibrosis / Q000188:drug therapy / Q000209:etiology; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D017379:Hypertrophy, Left Ventricular / Q000188:drug therapy / Q000209:etiology; D017275:Isradipine / Q000627:therapeutic use; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000209:etiology
D000959:Antihypertensive Agents; D004656:Enalapril; D004110:Diltiazem; D017298:Bisoprolol; D017275:Isradipine