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Q J Med 2003; 96: 449-452
© 2003 Association of Physicians

Commentary

Should we add screening for and treating left ventricular hypertrophy to the management of all patients needing secondary prevention of cardiovascular disease?

A.D. Struthers and J. Davies

From the Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital, Dundee, UK

The first 150 words of the full text of this article appear below.


   Introduction
 
Patients with overt vascular disease (TIA, CVA, peripheral vascular disease, etc.) and patients with diabetes are both well known to be at exceptionally high risk of cardiac death, and are generally thought to need more intensive risk factor control, i.e. secondary prevention. Their high risk of cardiac death is generally attributed to coincidental coronary artery disease, leading to cardiac death due to fresh ischaemic events. While coronary disease is undoubtedly important, left ventricular abnormalities could also be a major contributor to cardiac death in these patients, causing ’arrhythmic’ as opposed to ’ischaemic’ deaths. These left ventricular abnormalities consist of both left ventricular hypertrophy (LVH) and LV systolic dysfunction (LVSD). In this article, we focus only on LVH, as LVSD has often been discussed elsewhere.

That LVH is a risk factor is well established. In Framingham, the relative risk of cardiovascular mortality for every 50 g increment in echo LV mass . . . [Full Text of this Article]


   The new problem of ‘normotensive’ LVH patients
 

   LVH as a new therapeutic target
 

   Ways to treat LVH
 

   Summary
 

Address correspondence to Professor A.D. Struthers, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital, Dundee DD1 9SY. e-mail: a.d.struthers@dundee.ac.uk


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