Angiotensin‐converting enzyme inhibition, cell growth, and left ventricular hypertrophy in hypertension

Abstract

Summary: Left ventricular hypertrophy is now recognized as an important risk marker in cardiovascular morbidity and mortal ity. Left ventricular hypertrophy is an integral component of the complex pathophysiology of primary hypertension and results from mechanical, neurohumoral, and genetic factors . The renin-angiotensin system is involved with the production of left ventricular hypertrophy, not only through the effects on systemic arterial blood pressure but also by both direct and indirect effects on myocardial cell growth. The angiotensin-converting enzyme (ACE) inhibitors are effective drugs for reducing blood pressure in primary hypertension . ACE inhibitor therapy is also associated with regression of left ventricular hypertrophy and restoration of normal diastolic and systolic left ventricular function. Regression of left ventricular hypertrophy is associated with improved prognosis . Thus, when left ventricular hypertrophy regression is a goal of antihypertensive treatment, the ACE inhibitors are effective drugs .