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European Heart Journal 1993 14(Supplement F):2-6; doi:10.1093/eurheartj/14.suppl_F.2
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Ischaemia and left ventricular hypertrophy

J. E. Otterstad

Medical Department, Division of Cardiology, Vestfold Central Hospital Toensberg, Norway

Correspondence: Dr J. E. Otterstad, Medical Department, Division of Cardiology, Vestfold Central Hospital, N-3100 Toensberg, Norway.

Left ventricular hypertrophy (LVH), diagnosed by ECG and echocardiography, is commonly associated with coronary heart disease. Hypertensive patients with L VH and myocardial ischaemia may be at particular risk. The prevalence of ischaemia in hypertensive LVH was addressed in THAMES (Tenormin in Hypertension and Myocardial Ischaemia Epidemiological Survey), which comprised 205 men with hypertension. Echocardiography revealed LVH (definedas a left ventricular mass index ≥ l30 gm–2) in 140 patients (68%).

Of these patients with LVH, myocardial ischaemia was diagnosed on exercise ECG testing in 24%, and by thallium scintigraphy in 14%. Although not proven, a logical approach would be to improve the prognosis by reversing LVH and reducing ischaemia. A recent meta-analysis has indicated that angiotensin-converting enzyme (ACE) inhibitors are the most effective drugs in reversing L VH. But β-blockers may still be a logical first choice of drug, because of their valuable anti-ischaemic properties.

Key Words: Hypertension • echocardiography • left ventricular mass


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