Regression of left ventricular hypertrophy is a key goal of hypertension management.
Left ventricular hypertrophy (LVH) in patients with hypertension is associated with an increased risk for many cardiovascular events and predicts a higher mortality rate. The pathogenesis of LVH is complicated. In addition to the hemodynamic burden (pressure or volume overload) and demographic factors, several trophic humoral factors, such as angiotensin II, aldosterone, endothelin, leptin, and catecholamines, may also contribute to the development and progression of LVH. Effective antihypertensive therapy can reverse LVH as well as prevent its development. Regression of LVH decreases subsequent cardiovascular morbidity and mortality. The commonly used drugs have various effects on LVH. Angiotensin receptor blockers and angiotensin-converting enzyme inhibitors seem most effective. Several new agents, including direct antifibrotic drugs, aldosterone blockade, vasopeptidase inhibitors, and endothelin receptor antagonists that more specifically target the underlying pathogenesis of LVH may provide us with innovative approaches to treat LVH.
Zhang
Rubin
R
Louisiana State University Health Sciences Center, Department of Medicine, Section of Nephrology, 1542 Tulane Avenue, Box T3M-2/A319, New Orleans, LA 70112-2822, USA.
Crump
Judy
J
Reisin
Efrain
E
D047228:Angiotensin II Type 1 Receptor Blockers; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D065128:Endothelin Receptor Antagonists; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D011480:Protease Inhibitors / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D013841:Thiazepines / Q000627:therapeutic use; D062367:ortho-Aminobenzoates / Q000627:therapeutic use
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D065128:Endothelin Receptor Antagonists; D000451:Mineralocorticoid Receptor Antagonists; D011480:Protease Inhibitors; D011725:Pyridines; D013841:Thiazepines; D062367:ortho-Aminobenzoates; C106266:omapatrilat; C012293:tranilast