THE HEART AND VASCULAR CHANGES IN HYPERTENSION

Aim: To review present knowledge on the causes of cardiovascular chang es in hypertension and on the effects of antihypertensive treatment. B ackground: The clinical manifestations of hypertensive heart disease h ave changed considerably in recent decades, from predominantly cardiac failure to predominantly left ventricular hypertrophy, which is an in dependent risk factor for all cardiovascular events. This change paral lels the recent development of ultrasonic devices which make it possib le to investigate the vessels as well as the heart. These devices have shown that there are different types of cardiac remodeling, which are associated with different hemodynamic profiles. Treatment of cardiova scular remodeling: Recent studies have shown that antihypertensive tre atment, both pharmacological and non-pharmacological, can significantl y reduce left ventricular hypertrophy in hypertensive patients without jeopardizing the hemodynamic balance. However, hypertensive vessel di sease has been less extensively investigated, with many studies concen trating on the carotid arteries. There appears to be a correlation bet ween cardiac and carotid artery changes but so far there is no informa tion on the effects of the antihypertensive treatment on the carotid a lterations.