LEFT VENTRICULAR HYPERTROPHY IN ESSENTIAL HYPERTENSION: ACTUAL ASPECTS OF PATHOGENESIS, DIAGNOSIS AND TREATMENT
Left ventricular hypertrophy (LVH) is associated with unfavorable cardiovascular risk profile. LVH raises The risk of coronary heart disease in more than twice, stroke - three times more, heart failure - nearly 8 times more. According to our observational data (1916 patients with essential hypertension) 23% subjects had concentric LVH, 19% - eccentric LVH, 11% - concentric LV remodeling, 47% - normal LV geometry. Under additional analysis of 5714 cards of hypertensive patients, 0,91% of them had asymmetric LVH. In comparison with eccentric LVH persons, subjects with concentric LVH had higher systolic and diastolic blood pressure (p<0.001 for each parameter). Smoking was prevalent among concentric LVH patients much wider than among eccentric LVH ones (p=0.0001). Complicated forms of coronary heart disease were observed in eccentric LVH persons more frequently in comparison with concentric LVH patients (p<0.01). Modern approaches to LVH correction are associated with pharmacologic blockade of renin-angiotensin-aldosterone system (RAAS). Our data shown that antihypertensive 6 months therapy based on Quinapril in persons with severe asymmetric LVH (LV mass index 212 g/m<sup>2</sup>) was accompanied by marked decrease of left ventricular mass, overnight blood pressure levels and also by significant reduction of neurohumoral regulatory pattern.