[Progression and regression of heart hypertrophy in arterial hypertension: pathophysiology and clinical aspects].

The criteria of the degree of hypertrophy and dilatation are defined. On this basis, functional and therapeutical regimen of regression of cardiac hypertrophy (prazosin, clonidine, nifedipine) are analyzed in concentric as well as in excentric hypertrophy in patients with arterial hypertension. Regression of cardiac hypertrophy is possible by differentiated pharmacotherapy, e. g., by prazosin, calciumantagonists, clonidine, alphamethyldopa, ACE-inhibitors as well as by combination therapies (beta-receptor blocking agents plus diuretics plus vasodilators). By these therapeutical measurements improvements in ventricular function can be achieved. Coronary reserve can be improved, consecutively the ischemic risk of hypertrophied cardiac muscle may be reduced. By the availability of pharmacotherapeutical regression of cardiac hypertrophy differentiated pharmacotherapy is possible in cardiac hypertrophy in man. Parallel to the regression improvement in ventricular function is possible. It remains still investigated, whether pharmacotherapeutical regression of cardiac hypertrophy is associated with decrease in coronary and late myocardial complications and whether prognosis of hypertensive heart disease can be significantly improved.