Left ventricular hypertrophy resulting from systemic hypertension: adaptive advantage and adverse consequences.

Left ventricular hypertrophy is the most important cardiovascular consequence of chronic systemic hypertension. While ventricular hypertrophy is an adaptive response to increased work load that preserves cardiac output, it nonetheless has adverse consequences. These include gradual systolic and diastolic dysfunction leading to congestive heart failure, an increased incidence of ventricular arrhythmias, accelerated atherosclerosis of the coronary arteries, and alterations (anatomic and physiologic) in the coronary microvasculature. Additionally, the presence of hypertension and hypertrophy increases the likelihood of poor outcome when ischemic heart disease occurs. Chronic systemic hypertension is prevalent among African Americans, who are therefore at risk for the development of left ventricular hypertrophy and the increase in mortality that accompanies the hypertrophic response.