Cardiac remodeling in systemic hypertension

Experimental and clinical studies provide evidence that hypertension is causally related to adverse cardiac structural changes. These changes are induced by both hemodynamic and nonhemodynamic factors. There is accumulating evidence from several small and large clinical trials that various classes of antihypertensive therapy prevent and regress left ventricular hypertrophy and myocardial fibrosis. In patients with hypertensive heart disease, the components of therapy must comprise optimization of blood pressure and regression of left ventricular hypertrophy. Future targets of therapy in hypertensive heart disease may include regression of myocardial fibrosis, normalization of left atrium size, and improvement in left ventricle diastolic function.