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Left Ventricular Hypertrophy and Treatment with Renin Angiotensin System Inhibition

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Book cover Renin Angiotensin System and Cardiovascular Disease

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Hypertensive left ventricular hypertrophy can be considered as the macroscopic result of the exaggerated growth response of the cardiomyocyte to the mechanical stress imposed on the left ventricle by the progressively increasing arterial pressure. Besides cardiomyocyte hypertrophy exaggerated cardiomyocyte apoptosis and alterations in the extracellular matrix and the microcirculation also develop, which lead to the structural remodeling of the myocardium. These changes may help to explain why left ventricular hypertrophy represents not only an adaptation to increased pressure load but also an independent risk factor and a marker of risk of cardiovascular complications in hypertensive patients. Experimental evidence support the notion that angiotensin II contributes in a significant way to the development of hypertrophy and remodeling of the hypertensive left ventricle. In accordance with this, data from a large number of clinical studies have shown that long-term antihypertensive treatment with drugs inhibiting the renin agiotensin system, namely angiotensin-converting enzyme inhibitors and angiotensin type 1 receptor antagonists, is associated with regression of left ventricular hypertrophy, and this is associated with improvement in outcome and with the decrease of the risk of cardiovascular morbidity and mortality, even independently from changes of other risk factors, including blood pressure.

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Authors and Affiliations

  1. Ochsner Clinic Foundation, Louisiana State University School of Medicine, New Orleans, LA, USA

    Edward D. Frohlich MD

  2. Division of Cardiovascular Sciences, Centre of Applied Medical Research, University of Navarra, Pamplona, Spain

    Javier Díez MD,PhD

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Correspondence to Javier Díez MD,PhD .

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  1. Department of Pharmacology, University of Puerto Rico, San Juan, 00936, U.S.A.

    Walmor C. DeMello

  2. Ochsner Clinic Foundation, Jefferson Highway 1514 , New Orleans, 70121, U.S.A.

    Edward D. Frohlich

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Frohlich, E.D., Díez, J. (2009). Left Ventricular Hypertrophy and Treatment with Renin Angiotensin System Inhibition. In: DeMello, W., Frohlich, E. (eds) Renin Angiotensin System and Cardiovascular Disease. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-60761-186-8_9

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