eMedicine Specialties > Cardiology > Atherosclerosis and Risk Factors

Hypertensive Heart Disease: Follow-up

Author: Kamran Riaz, MD, Clinical Assistant Professor, Department of Internal Medicine, Section of Cardiology, Wright State University School of Medicine
Coauthor(s): Aqeel Ahmed, MD, Staff Physician, Department of Pathology, University of Missouri at Kansas City
Contributor Information and Disclosures

Updated: Aug 31, 2009

Follow-up

Further Inpatient Care

  • Daily weight and accurate fluid balance in patients with heart failure
  • Assessment of effectiveness and choice of antihypertensive treatment
  • Assessment of presence or absence of coronary artery disease and degree of LV systolic function
  • Reinforcement of dietary advice
  • Reinforcement of advice regarding importance of regular exercise
  • Workup for secondary causes of hypertension if not already performed

Further Outpatient Care

  • Assessment of patient dietary habits and exercise pattern
  • Assessment of medication effectiveness
  • Assessment of adverse effects of various medications: Obtain urinalysis and BUN, creatinine, and electrolyte levels to rule out renal insufficiency and electrolyte imbalances secondary to medications and to quantitate proteinuria.
  • Assessment of patient compliance with medications
  • Screening for complications related to hypertension, such as cerebrovascular disease, hypertensive retinopathy, worsening heart failure, and renal failure
  • Surveillance for LVH by ECG or echocardiography
  • Assessment of effects of other medications: Advise the patient to avoid taking over-the-counter medications, such as commonly used nonsteroidal anti-inflammatory drugs, cough suppressants and decongestants containing sympathomimetics, which potentially can raise BP.

Deterrence/Prevention

  • Low-sodium diet
  • Fresh fruits and vegetable diet
  • Regular aerobic exercise
  • Avoidance of obesity

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose a correctible cause of hypertension
  • Failure to diagnose and adequately treat hypertension
  • Failure to recognize and aggressively treat LVH
  • Failure to provide adequate treatment for diastolic and systolic LV dysfunction
  • Failure to identify hypertension as a cause of heart failure
  • Failure to identify and treat other cardiovascular risk factors such as hypercholesterolemia, obesity, and coronary artery disease
  • Failure to provide adequate dietary advice

Special Concerns

  • LVH should be treated aggressively because patients with LVH represent the subgroup of patients at the highest risk for cardiovascular events and mortality.
  • Adequately control BP 24 h/d.
  • Identify and treat other coexisting risk factors for increased cardiovascular events, such as hyperlipidemia, obesity, and coronary artery disease.
  • African Americans have a higher prevalence of and mortality rate from hypertensive heart disease, and LVH in African Americans should be identified and treated more aggressively than that in other groups.
  • Diet pills should be avoided.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Alan D Forker, MD to the development and writing of this article.



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Follow-up: Hypertensive Heart Disease
Multimedia: Hypertensive Heart Disease
References
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References

  1. Cabezas M, Comellas A, Ramon Gomez J, et al. [Comparison of the sensitivity and specificity of the electrocardiography criteria for left ventricular hypertrophy according to the methods of Romhilt-Estes, Sokolow-Lyon, Cornell and Rodriguez Padial]. Rev Esp Cardiol. Jan 1997;50(1):31-5. [Medline].

  2. Kahn S, Frishman WH, Weissman S, et al. Left ventricular hypertrophy on electrocardiogram: prognostic implications from a 10-year cohort study of older subjects: a report from the Bronx Longitudinal Aging Study. J Am Geriatr Soc. May 1996;44(5):524-9. [Medline].

  3. Gandhi SK, Powers JC, Nomeir AM, et al. The pathogenesis of acute pulmonary edema associated with hypertension. N Engl J Med. Jan 4 2001;344(1):17-22. [Medline].

  4. Ghali JK, Kadakia S, Cooper RS, Liao YL. Impact of left ventricular hypertrophy on ventricular arrhythmias in the absence of coronary artery disease. J Am Coll Cardiol. May 1991;17(6):1277-82. [Medline].

  5. Jouven X, Desnos M, Guerot C, Ducimetiere P. Predicting sudden death in the population: the Paris Prospective Study I. Circulation. Apr 20 1999;99(15):1978-83. [Medline].

  6. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. May 9 2001;285(18):2370-5. [Medline].

  7. Yamasaki N, Kitaoka H, Matsumura Y, et al. Heart failure in the elderly. Intern Med. May 2003;42(5):383-8. [Medline].

  8. Kannel WB, Cobb J. Left ventricular hypertrophy and mortality--results from the Framingham Study. Cardiology. 1992;81(4-5):291-8. [Medline].

  9. Liao Y, Cooper RS, Mensah GA, McGee DL. Left ventricular hypertrophy has a greater impact on survival in women than in men. Circulation. Aug 15 1995;92(4):805-10. [Medline].

  10. Burke AP, Farb A, Liang YH, et al. Effect of hypertension and cardiac hypertrophy on coronary artery morphology in sudden cardiac death. Circulation. Dec 15 1996;94(12):3138-45. [Medline].

  11. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. Jan 27 2009;119(3):e21-181. [Medline].

  12. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. May 21 2003;289(19):2560-72. [Medline].

  13. [Best Evidence] Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. May 1 2008;358(18):1887-98. [Medline].

  14. Elmer PJ, Grimm R Jr, Laing B, et al. Lifestyle intervention: results of the Treatment of Mild Hypertension Study (TOMHS). Prev Med. Jul 1995;24(4):378-88. [Medline].

  15. Hajjar IM, Grim CE, George V, Kotchen TA. Impact of diet on blood pressure and age-related changes in blood pressure in the US population: analysis of NHANES III. Arch Intern Med. Feb 26 2001;161(4):589-93. [Medline].

  16. Hypertension Prevention Trial Research Group. The Hypertension Prevention Trial: three-year effects of dietary changes on blood pressure. Arch Intern Med. Jan 1990;150(1):153-62. [Medline].

  17. Aguilera MT, de la Sierra A, Coca A, et al. Effect of alcohol abstinence on blood pressure: assessment by 24-hour ambulatory blood pressure monitoring. Hypertension. Feb 1999;33(2):653-7. [Medline].

  18. Forman JP, Stampfer MJ, Curhan GC. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. Jul 22 2009;302(4):401-11. [Medline].

  19. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ. Apr 28 2007;334(7599):885. [Medline].

  20. Conlin PR, Chow D, Miller ER 3rd, et al. The effect of dietary patterns on blood pressure control in hypertensive patients: results from the Dietary Approaches to Stop Hypertension (DASH) trial. Am J Hypertens. Sep 2000;13(9):949-55. [Medline].

  21. Conlin PR. The dietary approaches to stop hypertension (DASH) clinical trial: implications for lifestyle modifications in the treatment of hypertensive patients. Cardiol Rev. Sep-Oct 1999;7(5):284-8. [Medline].

  22. Moore TJ, Vollmer WM, Appel LJ, et al. Effect of dietary patterns on ambulatory blood pressure : results from the Dietary Approaches to Stop Hypertension (DASH) Trial. DASH Collaborative Research Group. Hypertension. Sep 1999;34(3):472-7. [Medline].

  23. Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. Jan 4 2001;344(1):3-10. [Medline].

  24. Svetkey LP, Sacks FM, Obarzanek E. The DASH Diet, Sodium Intake and Blood Pressure Trial (DASH-sodium): rationale and design. DASH-Sodium Collaborative Research Group. J Am Diet Assoc. Aug 1999;99(8 Suppl):S96-104. [Medline].

  25. Manolio TA, Levy D, Garrison RJ, et al. Relation of alcohol intake to left ventricular mass: The Framingham Study. J Am Coll Cardiol. Mar 1 1991;17(3):717-21. [Medline].

  26. Klatsky AL, Friedman GD, Armstrong MA. The relationships between alcoholic beverage use and other traits to blood pressure: a new Kaiser Permanente study. Circulation. Apr 1986;73(4):628-36. [Medline].

  27. Kokkinos PF, Papademetriou V. Exercise and hypertension. Coron Artery Dis. Mar 2000;11(2):99-102. [Medline].

  28. Mahamat A, Richard F, Arveiler D, et al. Body mass index, hypertension and 5-year coronary heart disease incidence in middle aged men: the PRIME study. J Hypertens. Mar 2003;21(3):519-24. [Medline].

  29. [Best Evidence] Jamerson K, Weber MA, Bakris GL, Dahlöf B, Pitt B, Shi V, et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. Dec 4 2008;359(23):2417-28. [Medline].

  30. Henderson BC, Sen U, Reynolds C, Moshal KS, Ovechkin A, Tyagi N. Reversal of systemic hypertension-associated cardiac remodeling in chronic pressure overload myocardium by ciglitazone. Int J Biol Sci. 2007;3(6):385-92. [Medline].

  31. Weir RA, McMurray JJ, Puu M, Solomon SD, Olofsson B, Granger CB, et al. Efficacy and tolerability of adding an angiotensin receptor blocker in patients with heart failure already receiving an angiotensin-converting inhibitor plus aldosterone antagonist, with or without a beta blocker. Findings from the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Added trial. Eur J Heart Fail. Feb 2008;10(2):157-63. [Medline].

  32. Okin PM, Devereux RB, Harris KE, Jern S, Kjeldsen SE, Julius S. Regression of electrocardiographic left ventricular hypertrophy is associated with less hospitalization for heart failure in hypertensive patients. Ann Intern Med. Sep 4 2007;147(5):311-9. [Medline].

  33. [Best Evidence] Sinha R, Cross AJ, Graubard BI, Leitzmann MF, Schatzkin A. Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med. Mar 23 2009;169(6):562-71. [Medline].

  34. Carter BL, Ernst ME, Cohen JD. Hydrochlorothiazide versus chlorthalidone: evidence supporting their interchangeability. Hypertension. Jan 2004;43(1):4-9. [Medline].

  35. Oparil S. Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT): practical implications. Hypertension. May 2003;41(5):1006-9. [Medline].

  36. Cardiac Insufficiency Bisoprolol Study II. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet. Jan 2 1999;353(9146):9-13. [Medline].

  37. Greenberg B, Quinones MA, Koilpillai C, et al. Effects of long-term enalapril therapy on cardiac structure and function in patients with left ventricular dysfunction. Results of the SOLVD echocardiography substudy. Circulation. May 15 1995;91(10):2573-81. [Medline].

  38. Konstam MA, Kronenberg MW, Rousseau MF, et al. Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dilatation in patients with asymptomatic systolic dysfunction. SOLVD (Studies of Left Ventricular Dysfunction) Investigators. Circulation. Nov 1993;88(5 Pt 1):2277-83. [Medline].

  39. Gottdiener JS, Thurmann PA, Kenedi P, et al. Influence of the angiotensin II antagonist valsartan on left ventricular hypertrophy in patients with essential hypertension. Circulation. Aug 10 1999;100(6):685-8. [Medline].

  40. Brilla CG, Matsubara LS, Weber KT. Antifibrotic effects of spironolactone in preventing myocardial fibrosis in systemic arterial hypertension. Am J Cardiol. Jan 21 1993;71(3):12A-16A. [Medline].

  41. Almendral J, Villacastin JP, Arenal A, et al. Evidence favoring the hypothesis that ventricular arrhythmias have prognostic significance in left ventricular hypertrophy secondary to systemic hypertension. Am J Cardiol. Nov 2 1995;76(13):60D-63D. [Medline].

  42. Dahlof B. Left ventricular hypertrophy and angiotensin II antagonists. Am J Hypertens. Feb 2001;14(2):174-82. [Medline].

  43. Dahlof B, Pennert K, Hansson L. Reversal of left ventricular hypertrophy in hypertensive patients. A metaanalysis of 109 treatment studies. Am J Hypertens. Feb 1992;5(2):95-110. [Medline].

  44. Dibas AI, Rezazadeh SM, Vassan R, et al. Mechanism of vasopressin-induced increase in intracellular Ca2+ in LLC- PK1 porcine kidney cells. Am J Physiol. Mar 1997;272(3 Pt 1):C810-7. [Medline].

  45. Drayer JI, Weber MA, DeYoung JL. BP as a determinant of cardiac left ventricular muscle mass. Arch Intern Med. Jan 1983;143(1):90-2. [Medline].

  46. Fagard R, Pardaens K. Left ventricular diastolic function predicts outcome in uncomplicated hypertension. Am J Hypertens. Jun 2001;14(6 Pt 1):504-8. [Medline].

  47. Galderisi M, Petrocelli A, Alfieri A, et al. Impact of ambulatory blood pressure on left ventricular diastolic dysfunction in uncomplicated arterial systemic hypertension. Am J Cardiol. Mar 15 1996;77(8):597-601. [Medline].

  48. Galderisi M, Petrocelli A, Fakher A, et al. Influence of nighttime blood pressure on left atrial size in uncomplicated arterial systemic hypertension. Am J Hypertens. Aug 1997;10(8):836-42. [Medline].

  49. Ghali JK, Liao Y, Simmons B, et al. The prognostic role of left ventricular hypertrophy in patients with or without coronary artery disease. Ann Intern Med. Nov 15 1992;117(10):831-6. [Medline].

  50. Gillman MW, Kannel WB, Belanger A, D'Agostino RB. Influence of heart rate on mortality among persons with hypertension: the Framingham Study. Am Heart J. Apr 1993;125(4):1148-54. [Medline].

  51. Harrap SB, Dominiczak AF, Fraser R, et al. Plasma angiotensin II, predisposition to hypertension, and left ventricular size in healthy young adults. Circulation. Mar 15 1996;93(6):1148-54. [Medline].

  52. Hjalmarson A, Goldstein S, Fagerberg B, et al. Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the Metoprolol CR/XL Randomized Intervention Trial in congestive heart failure (MERIT-HF). MERIT-HF Study Group. JAMA. Mar 8 2000;283(10):1295-302. [Medline].

  53. Iriarte M, Murga N, Sagastagoitia D, et al. Congestive heart failure from left ventricular diastolic dysfunction in systemic hypertension. Am J Cardiol. Feb 1 1993;71(4):308-12. [Medline].

  54. Kannel WB. Left ventricular hypertrophy as a risk factor: the Framingham experience. J Hypertens Suppl. Dec 1991;9(2):S3-8; discussion S8-9. [Medline].

  55. Karpanou EA, Vyssoulis GP, Psichogios A, et al. Regression of left ventricular hypertrophy results in improvement of QT dispersion in patients with hypertension. Am Heart J. Nov 1998;136(5):765-8. [Medline].

  56. Levy D, Garrison RJ, Savage DD, et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. May 31 1990;322(22):1561-6. [Medline].

  57. Levy D, Larson MG, Vasan RS, et al. The progression from hypertension to congestive heart failure. JAMA. May 22-29 1996;275(20):1557-62. [Medline].

  58. Levy D, Salomon M, D''Agostino RB, et al. Prognostic implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy. Circulation. Oct 1994;90(4):1786-93. [Medline].

  59. Liao Y, Cooper RS, Durazo-Arvizu R, et al. Prediction of mortality risk by different methods of indexation for left ventricular mass. J Am Coll Cardiol. Mar 1 1997;29(3):641-7. [Medline].

  60. Liebson PR, Grandits G, Prineas R, et al. Echocardiographic correlates of left ventricular structure among 844 mildly hypertensive men and women in the Treatment of Mild Hypertension Study (TOMHS). Circulation. Feb 1993;87(2):476-86. [Medline].

  61. Liebson PR, Grandits GA, Dianzumba S, et al. Comparison of five antihypertensive monotherapies and placebo for change in left ventricular mass in patients receiving nutritional- hygienic therapy in the Treatment of Mild Hypertension Study (TOMHS). Circulation. Feb 1 1995;91(3):698-706. [Medline].

  62. Liu P, Sole MJ. What is the relevance of apoptosis to the myocardium?. Can J Cardiol. Apr 1999;15 Suppl B:8B-10B. [Medline].

  63. Magometschnigg D, Brandt D, Hofmann R, et al. Treatment of left ventricular hypertrophy in hypertensive patients with a combination of verapamil and captopril--a multicenter study. Int J Clin Pharmacol Ther. Sep 1997;35(9):389-96. [Medline].

  64. Mammarella A, Paradiso M, Basili S, et al. Morphologic left ventricular patterns and prevalence of high-grade ventricular arrhythmias in the normotensive and hypertensive elderly. Adv Ther. Sep-Oct 2000;17(5):222-9. [Medline].

  65. Mantero F, Lucarelli G. Aldosterone antagonists in hypertension and heart failure. Ann Endocrinol (Paris). Feb 2000;61(1):52-60. [Medline].

  66. Mathew J, Davidson S, Narra L, et al. Etiology and characteristics of congestive heart failure in blacks. Am J Cardiol. Dec 15 1996;78(12):1447-50. [Medline].

  67. Mayet J, Ariff B, Wasan B, et al. Improvement in midwall myocardial shortening with regression of left ventricular hypertrophy. Hypertension. Nov 2000;36(5):755-9. [Medline].

  68. Mayet J, Chapman N, Shahi M, et al. The effects on cardiac arrhythmias of antihypertensive therapy causing regression of left ventricular hypertrophy. Am J Hypertens. Jun 1997;10(6):611-8. [Medline].

  69. Mensah GA, Francis CK, Crawford MJ, et al. Complications of hypertension: the heart. Cardiology. 2000;1:3-4, 1-12.

  70. Messerli FH, Grodzicki T. Hypertension, left ventricular hypertrophy, ventricular arrhythmias and sudden death. Eur Heart J. Sep 1992;13 Suppl D:66-9. [Medline].

  71. Myslinski W, Mosiewicz J, Ryczak E, et al. Right ventricular function in systemic hypertension. J Hum Hypertens. Mar 1998;12(3):149-55. [Medline].

  72. Neutel JM, Smith DH. Improving patient compliance: a major goal in the management of hypertension. J Clin Hypertens (Greenwich). Mar-Apr 2003;5(2):127-32. [Medline].

  73. Norman JE Jr, Levy D. Improved electrocardiographic detection of echocardiographic left ventricular hypertrophy: results of a correlated data base approach. J Am Coll Cardiol. Oct 1995;26(4):1022-9. [Medline].

  74. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. N Engl J Med. May 23 1996;334(21):1349-55. [Medline].

  75. Papademetriou V, Kokkinos PF. The role of exercise in the control of hypertension and cardiovascular risk. Curr Opin Nephrol Hypertens. Sep 1996;5(5):459-62. [Medline].

  76. Phillips RA, Diamond JA. Left ventricular hypertrophy, congestive heart failure, and coronary flow reserve abnormalities in hypertension. In: Oparil S, Weber MA, eds. Hypertension: A Companion to Brenner and Rector's The Kidney. Philadelphia, PA: WB Saunders; 2000:244-67.

  77. Pitt B. Regression of left ventricular hypertrophy in patients with hypertension: blockade of the renin-angiotensin-aldosterone system. Circulation. Nov 10 1998;98(19):1987-9. [Medline].

  78. Pitt B, Williams G, Remme W, Martinez F, Lopez-Sendon J, Zannad F, et al. The EPHESUS trial: eplerenone in patients with heart failure due to systolic dysfunction complicating acute myocardial infarction. Eplerenone Post-AMI Heart Failure Efficacy and Survival Study. Cardiovasc Drugs Ther. Jan 2001;15(1):79-87. [Medline].

  79. Pons-Llado G, Ballester M, Borras X, et al. Myocardial cell damage in human hypertension. J Am Coll Cardiol. Dec 2000;36(7):2198-203. [Medline].

  80. Redfield MM, Jacobsen SJ, Burnett JC Jr, Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA. Jan 8 2003;289(2):194-202. [Medline].

  81. Results of the Trials of Hypertension Prevention, Phase I. The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels. Results of the Trials of Hypertension Prevention, Phase I. JAMA. Mar 4 1992;267(9):1213-20. [Medline].

  82. Schoen FJ. The heart. In: Cotran RS, Kumar V, Robbins SL, eds. Robbins Pathologic Basis of Disease. 1994. 5th ed. Philadelphia, PA: WB Saunders; 1994:541-2.

  83. Schussheim AE, Diamond JA, Phillips RA. Left ventricular midwall function improves with antihypertensive therapy and regression of left ventricular hypertrophy in patients with asymptomatic hypertension. Am J Cardiol. Jan 1 2001;87(1):61-5. [Medline].

  84. Sheridan DJ. Regression of left ventricular hypertrophy: do antihypertensive classes differ?. J Hypertens Suppl. Jul 2000;18(3):S21-7. [Medline].

  85. Simpson TE, Dansky HM, Buttrick PM. Molecular genetic mechanisms of cardiac hypertrophy. Cardiovasc Risk Factors. 1995;5:93-108.

  86. Stokes J 3rd, Kannel WB, Wolf PA, et al. Blood pressure as a risk factor for cardiovascular disease. The Framingham Study--30 years of follow-up. Hypertension. May 1989;13(5 Suppl):I13-8. [Medline].

  87. Sullivan JM, Vander Zwaag RV, el-Zeky F, et al. Left ventricular hypertrophy: effect on survival. J Am Coll Cardiol. Aug 1993;22(2):508-13. [Medline].

  88. Sundstrom J, Lind L, Arnlov J, et al. Echocardiographic and electrocardiographic diagnoses of left ventricular hypertrophy predict mortality independently of each other in a population of elderly men. Circulation. May 15 2001;103(19):2346-51. [Medline].

  89. Tedesco MA, Ratti G, Aquino D, et al. Effects of losartan on hypertension and left ventricular mass: a long- term study. J Hum Hypertens. Aug 1998;12(8):505-10. [Medline].

  90. Vakili BA, Okin PM, Devereux RB. Prognostic implications of left ventricular hypertrophy. Am Heart J. Mar 2001;141(3):334-41. [Medline].

  91. Verdecchia P, Schillaci G, Borgioni C, et al. Prognostic value of left ventricular mass and geometry in systemic hypertension with left ventricular hypertrophy. Am J Cardiol. Jul 15 1996;78(2):197-202. [Medline].

  92. Viberti G. The need for tighter control of cardiovascular risk factors in diabetic patients. J Hypertens Suppl. Mar 2003;21 Suppl 1:S3-6. [Medline].

  93. Visser FC. Congestive heart failure: pathophysiology and management with special reference to systemic hypertension. J Cardiovasc Pharmacol. 1991;18 Suppl 4:S8-11. [Medline].

  94. Vuille C, Weyman AE. Left ventricle I: General considerations, assessment of chamber size and function. In: Weyman AE, ed. Principles and Practice of Echocardiography. 2nd ed. Philadelphia, PA: Lea & Febiger; 1994:599-605.

  95. Weber KT, Brilla CG, Campbell SE, et al. Myocardial fibrosis: role of angiotensin II and aldosterone. Basic Res Cardiol. 1993;88 Suppl 1:107-24. [Medline].

  96. Weber KT, Brilla CG, Campbell SE, et al. Pathologic hypertrophy with fibrosis: the structural basis for myocardial failure. Blood Press. Aug 1992;1(2):75-85. [Medline].

  97. Weber KT, Brilla CG, Janicki JS, et al. Myocardial fibrosis: role of ventricular systolic pressure, arterial hypertension, and circulating hormones. Basic Res Cardiol. 1991;86 Suppl 3:25-31. [Medline].

  98. Yoshitomi Y, Nishikimi T, Abe H, et al. Left ventricular systolic and diastolic function and mass before and after antihypertensive treatment in patients with essential hypertension. Hypertens Res. Mar 1997;20(1):23-8. [Medline].

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Further Reading

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Keywords

left ventricular hypertrophy, congestive heart failure, hypertension, high blood pressure, hyperpiesis, hyperpiesia, angina, myocardial infarction, MI, heart attack, coronary artery disease

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Contributor Information and Disclosures

Author

Kamran Riaz, MD, Clinical Assistant Professor, Department of Internal Medicine, Section of Cardiology, Wright State University School of Medicine
Kamran Riaz, MD is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Medical Association, American Society of Echocardiography, Ohio State Medical Association, and Royal College of Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Aqeel Ahmed, MD, Staff Physician, Department of Pathology, University of Missouri at Kansas City
Aqeel Ahmed, MD is a member of the following medical societies: American Society for Clinical Pathology
Disclosure: Nothing to disclose.

Medical Editor

Hanumant Deshmukh, MD †, Former Chief of Cardiology, Veterans Affairs Medical Center; Former Associate Professor, Department of Medicine, Rosalind Franklin University of Medicine and Science
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

CME Editor

Amer Suleman, MD, Consultant in Electrophysiology and Cardiovascular Medicine, Department of Internal Medicine, Division of Cardiology, Medical City Dallas Hospital
Amer Suleman, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Institute of Stress, American Society of Hypertension, Federation of American Societies for Experimental Biology, Royal Society of Medicine, and Society of Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

Chief Editor

Yasmine Subhi Ali, MD, MSCI, Assistant Professor of Medicine, Director of Preventive Cardiology, Director of Echocardiography, Meharry Medical College; Assistant Clinical Professor of Medicine, Vanderbilt University School of Medicine
Yasmine Subhi Ali, MD, MSCI is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, American Society of Echocardiography, American Society of Nuclear Cardiology, and National Lipid Association
Disclosure: Pfizer I own a small number of shares of Pfizer stock. These were NOT given to me by Pfizer, but rather purchased by myself as a personal investor for my diversified investment portfolio. None

 
 
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