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The role of renin–angiotensin–aldosterone system inhibition in the regression of hypertensive left ventricular hypertrophy: the evidence of the last three decades

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Abstract

Hypertension is a leading cause of cardiovascular mortality and morbidity. The development of left ventricular hypertrophy (LVH) in hypertension is an independent predictor of adverse cardiovascular outcomes. Conversely, regression of LVH is associated with better prognosis. Lowering of blood pressure in patients with hypertension is the unequivocal determinant of regression of LVH. Unless otherwise contraindicated, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) are drugs of first choice in patients with essential hypertension with LVH. In this article, we summarise the preclinical and clinical evidence of the last 3 decades that established the preferential use of ACEIs/ARBs in hypertensive heart disease.

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Authors and Affiliations

  1. Department of Pharmacology, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India

    Shah Newaz Ahmed, Ratinder Jhaj & Balakrishnan Sadasivam

  2. Department of General Medicine, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India

    Rajnish Joshi

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  1. Shah Newaz Ahmed
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  2. Ratinder Jhaj
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Contributions

SNA, RJ, BS and RJ contributed to the conception and design of this work. Data acquisition and analysis was performed by SNA and RJ. SNA drafted the article, which was then thoroughly revised and edited by RJ, BS and RJ.

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Correspondence to Shah Newaz Ahmed.

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Shah Newaz Ahmed, Ratinder Jhaj, Balakrishnan Sadasivam and Rajnish Joshi declare no conflicts of interest.

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Ahmed, S.N., Jhaj, R., Sadasivam, B. et al. The role of renin–angiotensin–aldosterone system inhibition in the regression of hypertensive left ventricular hypertrophy: the evidence of the last three decades. Drugs Ther Perspect 36, 509–517 (2020). https://doi.org/10.1007/s40267-020-00769-z

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