The Impact of Reducing Hypertensive Left Ventricular Hypertrophy on Sudden Cardiac Death

Abstract

It has been well recognized that the presence of left ventricular hypertrophy (LVH) is an adverse feature in hypertension, with such patients having a substantially higher risk of cardiovascular events, including mortality and morbidity from heart failure, ventricular arrhythmias, death from myocardial infarction, sudden cardiac death and cerebrovascular episodes. ECG may show findings suggestive of hypertrophy but echocardiography is the preferred test for the evaluation of the presence and extent of hypertrophy. The reduction of blood pressure via life style interventions and with the use of antihypertensive agents reduces cardiac mass in patients with LVH. This reduction is related both to the degree of antihypertensive response and to the specific therapy used. It appears that the degree of regression is more pronounced with angiotensin-converting enzyme inhibitors and calcium channel blockers, especially non-dihydropyridines. The regression of LVH is accompanied by a reduction in sudden death, acute myocardial infarction and heart failure.