Moser M, Setaro J F
Yale University School of Medicine, New Haven, CT.
Eur Heart J. 1991 Sep;12(9):1034-9. doi: 10.1093/eurheartj/12.9.1034.
Regression of LVH is a reasonable adjunctive goal of blood pressure treatment, given the well described risks of hypertrophy and the possible benefits inherent in its reversal. Data suggest that any of the presently recommended agents for initial monotherapy, i.e. diuretics, beta adrenergic inhibitors, ACE inhibitors, or calcium blockers, are effective in achieving regression of hypertrophy if blood pressure lowering is achieved. While there may be other factors that play a role in the genesis and maintenance of cardiac hypertrophy in the hypertensive subject, it would appear that blood pressure elevation is probably the most important one. If reduction of blood pressure to normotensive levels can be achieved and maintained by the use of any of the antihypertensive agents (including the vasodilators, if used in combination with adrenergic inhibitors and/or diuretics), there is a reasonable chance that cardiac hypertrophy can be prevented or reversed and prognosis improved.
鉴于已充分描述的心肌肥厚风险及其逆转可能带来的益处，左心室肥厚的逆转是血压治疗合理的辅助目标。数据表明，如果能实现血压降低，目前推荐的用于初始单一治疗的任何药物，即利尿剂、β肾上腺素能抑制剂、血管紧张素转换酶抑制剂或钙通道阻滞剂，都能有效实现肥厚的逆转。虽然可能有其他因素在高血压患者心脏肥厚的发生和维持中起作用，但血压升高似乎可能是最重要的因素。如果使用任何一种抗高血压药物（包括血管扩张剂，如果与肾上腺素能抑制剂和/或利尿剂联合使用）能够将血压降低并维持在正常血压水平，那么就有合理的机会预防或逆转心脏肥厚并改善预后。
