Left Ventricular Hypertrophy, Congestive Heart Failure, and Coronary Flow Reserve Abnormalities in Hypertension

Hypertension and the Heart

“…First, it is well established that blood pressure (in particular, systolic) and nonhemodynamic factors both contribute to the development and progression of left ventricular hypertrophy. 9 These factors include genetic influences (DD genotype), renin-angiotensin-aldosterone activation, metabolic factors such as hyperinsulinemia and insulin resistance, and adrenergic neural influences on the heart and peripheral circulation as well. 9 The patterns of left ventricular hypertrophy differ substantially according to the type of the hemodynamic alteration, the eccentric forms being more frequently linked to a volume overload and the concentric ones to a blood pressure overload.…”

“…9 These factors include genetic influences (DD genotype), renin-angiotensin-aldosterone activation, metabolic factors such as hyperinsulinemia and insulin resistance, and adrenergic neural influences on the heart and peripheral circulation as well. 9 The patterns of left ventricular hypertrophy differ substantially according to the type of the hemodynamic alteration, the eccentric forms being more frequently linked to a volume overload and the concentric ones to a blood pressure overload. 9 Second, left ventricular hypertrophy represents an independent marker of cardiovascular risk.…”

“…9 The patterns of left ventricular hypertrophy differ substantially according to the type of the hemodynamic alteration, the eccentric forms being more frequently linked to a volume overload and the concentric ones to a blood pressure overload. 9 Second, left ventricular hypertrophy represents an independent marker of cardiovascular risk. Its detection in hypertensive patients is associated with a 3-fold to 4-fold increased incidence of fatal and nonfatal cardiovascular events.…”

“…Specific associations have been reported between left ventricular hypertrophy and coronary heart disease, carotid atherosclerotic plaques, stroke, atrial fibrillation, ventricular arrhythmias, and sudden death, making the overall cardiovascular risk of the hypertensive patient an extremely elevated one. [8][9][10] Third, there is unequivocal evidence from several studies (Figure 1) that cardiac organ damage correlates more closely with 24-hour blood pressure than that taken in the clinic or office. 11 This correlation, which has been also reported for other markers of end-organ damage such as cerebral lacunae (a measure of brain damage), carotid wall thickness (a variable reflecting the vascular atherosclerotic involvement) or microalbuminuria (index of early renal dysfunction), has been documented to be closer for systolic than for diastolic blood pressure.…”

Sovremennye podkhody k diagnostike arterial'noy gipertenzii

“…В последние годы нарушению диастолической функции уделяется большое внимание. Во-первых, диастолическая дисфункция является одним из наиболее ранних проявлений гипертонической болезни сердца и нередко предшествует развитию собственно ГЛЖ, то есть увеличению массы миокарда [14]. Во-вторых, диастолическая дисфункция может становиться самостоятельной причиной хронической сердечной недостаточности (ХСН) при сохранной систолической функции (так называемая диастолическая ХСН, или ХСН с сохранной систолической функцией).…”