Left ventricular hypertrophy--an important, often unrecognized risk factor

Epidemiological studies both in the general population and in series of hypertensive patients have shown the presence of left ventricular hypertrophy (LVH), as determined by echocardiography, to be a powerful risk factor for cardiovascular events. Although LVH is generally associated with hypertension, less than half of hypertensive patients develop LVH. Insulin resistance, endothelial dysfunction, increased blood viscosity, decreased arterial compliance, and increased angiotensin-converting enzyme activity have all been associated with the development of LVH. Although findings in observational studies suggest LVH regression to have a beneficial effect in terms of decreased cardiovascular risk, confirmation of this awaits the results of prospective clinical trials currently being carried out.