Regression of left ventricular hypertrophy in hypertension with alpha-adrenergic blockade: physiological basis and therapeutic implications.

Abstract

Left ventricular hypertrophy may be a serious consequence of chronic untreated hypertension since it may accentuate the risk of congestive heart failure, arrhythmias, coronary ischaemias and sudden death. Although haemodynamic factors may play a role in the genesis of left ventricular hypertrophy, certain neurohumoral mechanisms such as the adrenergic nervous system may induce left ventricular hypertrophy in patients with hypertension. There is considerable evidence to implicate adrenergic activation in the pathogenesis of left ventricular hypertrophy. Thus, adrenergic blockade may have a favourable impact on the course of left ventricular hypertrophy. Recent studies discussed in this paper have demonstrated that postsynaptic alpha-adrenergic blockers cause a significant reduction in the left ventricular mass. It is concluded that alpha-adrenergic blockers can be added to the list of antihypertensive drugs which can cause regression of left ventricular hypertrophy in patients with hypertension.