Towards a New Paradigm About Hypertensive Heart Disease

A new paradigm is emerging related to the impact of chronic hypertension on the cardiac parenchyma. Whereas left ventricular hypertrophy may be detected early and accurately in hypertensive patients by electrocardiography and echocardiography, newer cardiac imaging methods and the monitoring of several circulating biomarkers holds promise as a noninvasive tool for the diagnosis of myocardial remodeling. A large number of clinical studies have shown that long-term antihypertensive treatment may be associated with regression of left ventricular hypertrophy, and this is associated with the decrease of the risk of cardiovascular morbidity and mortality. However, because the remaining risk is unacceptably high, new therapeutic strategies aimed not just to decrease left ventricular mass, but also to repair myocardial remodeling are necessary. All of these aspects are reviewed in brief in this article.