Left ventricular hypertrophy and angiotensin II antagonists

Left ventricular hypertrophy in patients with hypertension is an important condition. It is associated with significant mortality and carries increased risk for developing nonfatal cardiovascular complications, including coronary heart disease. The pathogenesis of left ventricular hypertrophy is linked to activation of the renin-angiotensin system, with excessive production of angiotensin II believed to be responsible. The therapeutic benefit of blocking angiotensin II at the receptor with selective angiotensin II antagonists, a relatively new class of antihypertensive agents, is therefore considered for regression of left ventricular hypertrophy. Clinical evidence shows significant efficacy in reversing left ventricular hypertrophy in hypertensive patients after treatment with angiotensin II antagonists. Published data include open-label and randomized studies with losartan treatment for left ventricular hypertrophy, with fewer studies investigating the effects of valsartan, irbesartan, and candesartan.