HYPERTENSION, HYPERTROPHY, HORMONES, AND THE HEART

Mild-to-moderate hypertension is common, and its natural history is re asonably well defined. The association of elevated blood pressure with left ventricular hypertrophy, insulin resistance, renal dysfunction, and increased propensity toward athetosclerotic cardiovascular disease and ventricular arrhythmias has been characterized. These association s, however, are not well predicted by the level of blood pressure elev ation, suggesting some independence between blood pressure levels and cardiovascular complications. Although the reduction in pressure-relat ed outcomes caused by therapeutic interventions (e.g,, stroke) has bee n demonstrated, a similar reduction in many atherosclerotic outcomes h as not been definitively demonstrated. The latter observation may be r elated to a number of Factors but may be partly explained by the lock of direct correlation between blood pressure and cardiovascular outcom e. This review attempts to update available information on the interme diating factors mitigating the relation among blood pressure, adverse cardiovascular outcome, and the treatment of hypertension.