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The Role of the Sympathetic Nervous System in the Control of Left Ventricular Mass in Hypertension

  • Jan I. M. Drayer
  • Michael A. Weber
Conference paper

Abstract

In the past, the electrocardiogram and the chest x-ray have been used in the diagnosis of left ventricular hypertrophy in patients with hypertension. The presence of signs of hypertrophy on the electrocardiogram or the presence of an enlarged heart on the chest x-ray were considered as an important prognostic marker of cardiovascular complications. In fact, data from the Framingham Study have revealed that the presence of cardiac hypertrophy is a more important risk factor than blood pressure itself (Kannel et al. 1970). The five year mortality rate increases with the presence of left ventricular hypertrophy from 7 to 38% in men and from 4 to 20% in women. The risk of clinical manifestations of cardiovascular disease also increases significantly with the presence of left ventricular hypertrophy on the electrocardiogram. Patients with hypertrophy more often had a myocardial infarction, angina, congestive heart failure, signs of occlusive peripheral vascular disease or cerebrovascular accidents than those without left ventricular hypertrophy (Kannel 1975). Successful antihypertensive therapy may lead to regression of signs of hypertrophy on the electrocardiogram (Freis 1980).

Keywords

Muscle Mass Left Ventricular Hypertrophy Sympathetic Nervous System Cardiac Hypertrophy Left Ventricular Mass 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Ayobe MH, Tarazi RC (1983) /3-receptors and contractile reserve in left ventricular hypertrophy. Hypertension 5: 1191–1197Google Scholar
  2. 2.
    Borken AM, Jones M, Bell JH, Pierce JE (1982) Regional myocardial blood flow in left ventricular hypertrophy. J Thorac Cardiovasc Surg 84: 876–885Google Scholar
  3. 3.
    Capasso JM, Strobeck JE, Malhotra A, Scheuer J, Sonnenblick EH (1982) Contractile behavior of rat myocardium after reversal of hypertensive hypertrophy. Am J Physiol 242: H882 — H889PubMedGoogle Scholar
  4. 4.
    Corea L, Bentivoglio M, Verdecchia P (1981) Reversal of left ventricular hypertrophy in essential hypertension by early and long-term treatment with methyldopa. Clin Trials J 18: 380–394Google Scholar
  5. 5.
    Drayer JIM, Gardin JM, Weber MA, Aronow WS (1982) Changes in ventricular septal thickness during diuretic therapy. Clin Pharmacol Ther 32: 283–288PubMedCrossRefGoogle Scholar
  6. 6.
    Drayer JIM, Gardin JM, Weber MA (1983a) Echocardiographic left ventricular hypertrophy in hypertension. Chest 84: 217–221PubMedCrossRefGoogle Scholar
  7. 7.
    Drayer JIM, Gardin JM, Weber MA (1983b) Changes in cardiac muscle mass during vasodilation therapy of hypertension. Clin Pharmacol Ther 33: 727–732PubMedCrossRefGoogle Scholar
  8. 8.
    Drayer JIM, Weber MA, DeYoung JL (1983c) Blood pressure as a determinant of cardiac left ventricular muscle mass. Arch Intern Med 143: 90–92PubMedCrossRefGoogle Scholar
  9. 9.
    Drayer JIM, Weber MA, Gardin JM, Lipson JL (1983d) The effect on long-term antihypertensive therapy on cardiac anatomy in patients with essential hypertension. Am J Med 75: 116–120PubMedCrossRefGoogle Scholar
  10. 10.
    Drayer JIM, Weber MA, Gardin JM (1984) Cardiac left ventricular muscle mass and end-systolic wall stress during antihypertensive therapy. In: Messerli F and Tarazi RC (eds) The Heart and Hypertension. In pressGoogle Scholar
  11. 11.
    Fouad FM, Nakashima Y, Tarazi RC, Salcedo EE (1982) Reversal of left ventricular hypertrophy in hypertensive patients treated with methyldopa. Am J Cardiol 49: 795–801PubMedCrossRefGoogle Scholar
  12. 12.
    Freis ED (1980) Electrocardiographic changes in the course of antihypertensive treatment. Am J Med 75: 111–115Google Scholar
  13. 13.
    Garner, D, Laks M (1980) Is the physiological hypertrophy produced by a 3 month subhypertensive norepinephrine infusion blocked by propranolol? Circulation 62 (Suppl 3): 68Google Scholar
  14. 14.
    Inouye 1, Massie B, Loge D, Tonic N, Silverstein D, Simpson P, Tubau J (1984) Abnormal left ventricular filling: An early finding in mild to moderate systemic hypertension. Am J Cardiol 53: 120–126Google Scholar
  15. 15.
    Kannel WB, Gordon T, Castelli WP, Margolis JR (1970) Electrographic left ventricular hypertrophy and risk of coronary heart disease. The Framingham Study. Ann Int Med 72: 813–822Google Scholar
  16. 16.
    Kannel WB (1975) Epidemiology and Control of Hypertension. Paul O (ed) Yearbook Medical Publications, Chicago, p. 553–598Google Scholar
  17. 17.
    Kannel WB (1979) Theories and Use of ß-blockers in Hypertension and Angina. Roberts RH (ed) Yearbook Medical Publications, ChicagoGoogle Scholar
  18. 18.
    Kuwajima I, Kardon MB, Pegram BL, Sesoko S, Frohlich ED (1982) Regression of left ventricular hypertrophy in two-kidney one-clip Goldblatt hypertension. Hypertension 4: 113–118PubMedGoogle Scholar
  19. 19.
    Pegram BL, Frohlich ED (1983) Cardiovascular adjustment to antiadrenergic agents. Am J Med 75: 94–99PubMedCrossRefGoogle Scholar
  20. 20.
    Plotnick GD, Fisher ML, Wohl B, Hamilton JH, Hamilton BP (1984) Improvement in depressed cardiac function in hypertensive patients during pindolol treatment. Am J Med 76: 25–30PubMedCrossRefGoogle Scholar
  21. 21.
    Ruskoaha H (1983) Effects of drug treatment on hypertension and cardiac hypertrophy in spontaneously hypertensive rats. Acta Univ Ouluensis, D96, Pharmacol Physiol 17Google Scholar
  22. 22.
    Savage DD, Drayer JIM, Henry WL, Mathews EC Jr, Ware JH, Gardin JM (1979) Echocardiographic assessment of cardiac anatomy and function in hypertensive subjects. Circulation 59: 623–632PubMedCrossRefGoogle Scholar
  23. 23.
    Sen S (1983) Regression of cardiac hypertrophy. Experimental animal model. Am J Med 75: 87–93PubMedCrossRefGoogle Scholar
  24. 24.
    Simpson P (1983) Norepinephrine-stimulated hypertrophy of cultured rat myocardial cells is an alpha-I adrenergic response. J Clin Invest 72: 732–738PubMedCrossRefGoogle Scholar
  25. 25.
    Tomanek RJ, Bhatnagar RK, Schmid P, Brody MJ (1982) Role of catecholamines in myocardial cell hypertrophy in hypertensive rats. Am J Physiol 242: H1015–1021PubMedGoogle Scholar
  26. 26.
    Trimarco B, Ricciardelli B, DeLuca N, Volpe M, Veniero A, Cuocolo A, Condorelli M (1984) Effect of acebutolol on left ventricular hemodynamics and anatomy in systemic hypertension. Am J Cardiol 53: 791–796PubMedCrossRefGoogle Scholar
  27. 27.
    Wicker P, Tarawi R, Dallocchio M, Bricard H (1982) Coronary flow in experimental cardiac hypertrophy caused by arterial hypertension. Arch Mal Coeur 75: 133–136PubMedGoogle Scholar
  28. 28.
    Wollam GL, Hall WD, Porter VD, Douglas MB, Unger DJ, Blumenstein BA, Cotsonis GA, Knudtson ML, Feiner JM, Schlant RC (1983) Time course of regression of left ventricular hypertrophy in treated hypertensive patients. Am J Med 75: 100–110PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • Jan I. M. Drayer
    • 1
  • Michael A. Weber
    • 2
    • 3
  1. 1.Hypertension CenterVeterans Administration Medical CenterLong BeachUSA
  2. 2.Hypertension CenterVeterans Administration Medical CenterLong BeachUSA
  3. 3.Hypertension CenterUniversity of CaliforniaIrvineUSA

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