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Metabolic syndrome and biventricular hypertrophy in essential hypertension

Journal of Human Hypertension volume 23, pages 211–212 (2009)Cite this article

Long-standing hypertension is associated with left ventricular hypertrophy (LVH) that may be either concentric or eccentric. It has been shown that hypertension is also associated with hypertrophy and fibrosis of the right ventricle. 1 The hypertrophy of the right ventricle is not because of pressure overload, and therefore non-haemodynamic factors, such as angiotensin II, aldosterone, insulin, the sympathetic nervous system and endothelin may be involved in this process.

The contribution of non-haemodynamic factors to the development of cardiac hypertrophy may also explain why in several studies it has been shown that the increase in left ventricular mass preceded hypertension. For example, we followed 500 young healthy Israeli air force aviators, who underwent echocardiography at the start of their military service for an average period of 7.5±3.0 years.2 We showed that interventricular septal thickness predicted the development of systolic hypertension suggesting that interventricular septum thickening is not merely a result of long-term elevation of blood pressure. These results suggest that LVH is an early marker of hypertension and is caused by non-haemodynamic factors that are also responsible for hypertension, such as over activity of the sympathetic nervous system or the renin-angiotensin system. Heart muscle may be more sensitive than blood pressure to the activation of these systems, and heart muscle changes appear earlier than the elevation in blood pressure.

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  1. Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel Hashomer Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Hashomer, Israel

    E Grossman

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Grossman, E. Metabolic syndrome and biventricular hypertrophy in essential hypertension. J Hum Hypertens 23, 211–212 (2009). https://doi.org/10.1038/jhh.2008.145

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