The major structural and functional determinants of impaired left ventricular diastolic function in the hypertensive patient are reviewed, together with the indices normally used to detect this failure. The alteration of functional determinants can be quickly modified, while structural determinants are modified only over the long term. Drug therapy first affects the functional determinants, bringing about their attenuation and initiating the modification of the structural factors, thus accounting for the improvement in diastolic function over the long term.
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