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European Heart Journal 1992 13(Supplement G):53-60; doi:10.1093/eurheartj/13.suppl_G.53
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Effect of diuretic therapy on hypertensive left ventricular hypertrophy

B. M. Massie

University of California San Franscisco, U.S.A.

Correspondence: Barry Massie, MD, veterans Administration Medical Center, Cardiology Section (111C), 4150 Clement Street, San Francisco, CA94121, U.S.A.

Left ventricular hypertrophy (LVH) has been indentified as a major independent risk factor for cardiovascular morbidity in patients with essential hypertension. It is also established that antihypertensive drug therapy is associated with regression of LVH in many patients. However, it is unclear whether all antihypertensive agents are equally effective in regressing LVH and whether this process is drug-specific or primarily related to blood pressure control.

There is no universal agreement on the influence of diuretics on LVH in hypertension. Several major trials have shown consistent reversal of electrocardiographic manifestations of LVH during diuretic-based therapy. The results of studies employing echocardiographic measurements have been more variable; however, most echocardiographic studies have been flawed by lack of controls or blinding, short duration of follow-up, small sample size, inclusion of patients without LVH, and lack of consideration of previous or concomitant therapy. This review provides a critical examination of the available data on both sides of the question.

Key Words: Hypertension • left ventricular hypertrophy • diuretics


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