PREVENTION AND REDUCTION OF LEFT-VENTRICULAR HYPERTROPHY IN THE ELDERLY

Left ventricular hypertrophy (LVH) is both a target organ response to arterial hypertension and a disorder that may be responsible for incre asing risk of cardiovascular events, including coronary artery disease (CAD) events, in the elderly population. Hypertension and obesity are the strongest risk factors for LVH, and both disorders are more Likel y to occur with age. Not surprisingly, the prevalence of LVH markedly increases with age. Although LVH may initially be a compensatory mecha nism to reduce ventricular wall stress, substantial data indicate that as LVH progresses, coronary flow reserve is reduced, and CAD events a re increased. Furthermore, LVH leads to systolic and particularly, dia stolic ventricular dysfunction, and an increase in the prevalence and complexity of ventricular dysrhythmias. All types of cardiovascular mo rbidity and mortality also are increased in patients with LVH. Pharmac ologic and nonpharmacologic strategies that may decrease LVH and poten tially reduce cardiovascular morbidity and mortality in the elderly ar e reviewed.