Devereux R B
Division of Cardiology, New York Hospital-Cornell Medical Center, NY 10021.
Health Psychol. 1988;7 Suppl:89-104. doi: 10.1037/h0090273.
The greater sensitivity of echocardiography than electrocardiography has revealed left ventricular hypertrophy (LVH) to be present in 20% or more of patients with systemic hypertension, with the exact prevalence dependent both on how a population is selected and on the sex, race, and possibly age composition of its members. LVH is more closely related to blood pressure recorded in the patient's natural setting during normal activity or exercise-whether measured by portable recorder or home manometer-than to blood pressure measured by the physician. A subgroup of patients with mild essential hypertension exhibit high cardiac output and evidence of supernormal myocardial contractility in the absence of LVH, whereas among patients with more sustained hypertension, high ejection fractions may be associated with marked concentric LVH. Recent data indicate that echocardiographic detection of LVH identifies mildly hypertensive patients at significant risk, a finding that may aid identification of patients for drug treatment.
超声心动图比心电图具有更高的敏感性，这表明在20%或更多的系统性高血压患者中存在左心室肥厚（LVH），其确切患病率既取决于人群的选择方式，也取决于其成员的性别、种族以及可能的年龄构成。与医生测量的血压相比，LVH与患者在正常活动或运动期间自然状态下记录的血压（无论是通过便携式记录仪还是家用血压计测量）的关系更为密切。一小部分轻度原发性高血压患者表现为高心输出量以及在无LVH情况下心肌收缩力超常的证据，而在高血压持续时间更长的患者中，高射血分数可能与明显的同心性LVH相关。最近的数据表明，超声心动图检测到的LVH可识别出有显著风险的轻度高血压患者，这一发现可能有助于确定药物治疗的患者。
