Impact of arterial hypertension on the heart
Herpin, D.
La Revue du Praticien 49(5): 491-494
1999
ISSN/ISBN: 0035-2640 PMID: 10358398 Document Number: 502268
Heart involvement in systemic hypertension more often consists of a concentric left ventricular hypertrophy, rather than of an eccentric hypertrophy or of a left ventricular remodeling. These morphological abnormalities are seen in 25% of the hypertensive patients and can easily be diagnosed by using echocardiography. Underlying mechanisms of hypertensive left ventricular hypertrophy are of 2 types: mechanical, mainly leading to myocyte hypertrophy; neuro-hormonal, mainly resulting in a fibroblastic proliferation. Associated with hypertensive left ventricular hypertrophy is a poor spontaneous prognosis: arrhythmias, myocardial ischaemia (with or without narrowings of epicardial arteries), abnormalities in left ventricular diastolic function. Anti-hypertensive drugs result in an additional benefit, in terms of cardiovascular morbidity and mortality, when both a reduction in blood pressure and a regression of left ventricular hypertrophy can be achieved.