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May 15, 1996

Regression of Left Ventricular Hypertrophy: How and Why?

Author Affiliations

From the Department of Medicine, The New York Hospital—Cornell Medical Center, New York, NY.

JAMA. 1996;275(19):1517-1518. doi:10.1001/jama.1996.03530430061042

Numerous studies have established a close link between left ventricular hypertrophy (LVH) detected by electrocardiogram (ECG) and, more recently, echocardiogram and the risk of cardiovascular morbidity and mortality. In fact, increased echocardiographic LV mass has been shown to predict complications in both members of the general population1 and patients with hypertension2 more strongly than any other risk factor except advancing age. These findings have led to widespread acceptance of the idea that established LVH should be reversed by treatment. The effects on LVH of antihypertensive treatments alone have been studied in nearly 500 human trials and an even larger number of experimental ones.

See also p 1507.

What Have We Learned So Far?  The clear conclusion from this line of research is that LV mass decreases if blood pressure is substantially reduced by most classes of antihypertensive medications, with the possible exception of directly acting vasodilators.3,4 Intensive