[Left ventricular hypertrophy of the hypertensive patient. Approach to its pathogenesis and consequences].

The knowledge of the characteristics and consequences of left ventricular hypertrophy (LVH) in the hypertensive patient has greatly progressed in the past few years, owing to echocardiography. This examination provides a reliable and reproducible measurement, and therefore the left ventricular mass is used more and more as a severity index of hypertension and a mean of evaluation of the efficacy of the treatment. This attitude is justified in part by the poor prognosis of LVH. However, the pathogenesis of LVH in hypertension still presents numerous unknown facts. If the elevation of the post-charge seems to be the essential mechanism, other factors seem to have an important influence and explain the uneven effect of different hypertensive drugs at this level. Presently, there are several arguments in favor of the beneficial character of the regression of LVH in the hypertensive patient under treatment, but we will have to wait for the result of prognostic studies to use this property as a major objective of anti-hypertensive treatments.