Hypertension Unit, Department of Medicine and Experimental Oncology, University of Torino, Via Genova, 3, Turin, Italy.
Intern Emerg Med. 2010 Dec;5(6):469-79. doi: 10.1007/s11739-010-0405-6. Epub 2010 May 18.
Structural remodelling of the heart, known as left ventricular hypertrophy (LVH), is a consequence of systemic hypertension, and is associated with an increased risk of cardiovascular morbidity and mortality. Therefore, particular attention should be paid to the identification, prevention and treatment of this condition in hypertensive patients. LVH seems to benefit from all classes of anti-hypertensive drugs; however, antagonists of the renin-angiotensin-aldosterone system (RAAS) have demonstrated an additional benefit in the inhibition and reversal of myocardial interstitial fibrosis. Nevertheless, in evaluating the degree of arterial hypertension and organ damage, many neuro-hormonal systems are involved, primarily the sympathetic nervous system, thereby explaining the use of different classes of anti-hypertensive drugs to prevent or reduce LVH. The RAAS antagonists are actually the recommended anti-hypertensive agents to prevent organ damage in hypertensive subjects or in hypertensives with evidence of LVH to reduce cardiovascular mortality and morbidity.
心脏的结构重塑，即左心室肥厚（LVH），是系统性高血压的后果，并且与心血管发病率和死亡率的增加相关。因此，应特别注意识别、预防和治疗高血压患者的这种情况。LVH 似乎受益于所有类别的抗高血压药物；然而，肾素-血管紧张素-醛固酮系统（RAAS）的拮抗剂在抑制和逆转心肌间质纤维化方面表现出额外的益处。然而，在评估动脉高血压和器官损伤的程度时，许多神经激素系统都参与其中，主要是交感神经系统，从而解释了使用不同类别的抗高血压药物来预防或减少 LVH。RAAS 拮抗剂实际上是预防高血压患者器官损伤或有 LVH 证据的高血压患者心血管死亡率和发病率的推荐抗高血压药物。
