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Hypertension and left ventricular hypertrophy.

Left ventricular hypertrophy (LVH) is an abnormal increase in left ventricular mass. which is a marker for and contributes to coronary events, stroke, heart failure, peripheral arterial disease, and cardiovascular mortality in patients with hypertension (1-12). LVH is commonly measured by electrocardiography, echocardiography, and magnetic resonance imaging Concentric LVH is an increased left ventricular mass index with a relative wall thickness ≥0.45 (1). Eccentric LVH is an increased left ventricular mass index with a relative wall thickness <0.45 (1). Concentric left ventricular remodeling is a relative wall thickness ≥0.45 with a normal left ventricular mass index. Factors influencing left ventricular geometry in persons with hypertension include: (I) the severity, duration, and rapidity of onset of the increased pressure load; (II) the volume load; (III) age, race/ethnicity, and sex; (IV) comorbidities such as coronary artery disease, diabetes mellitus, obesity, and valvular heart disease; (V) the neurohormonal milieu; (VI) alterations of the extracellular matrix; and (VII) genetic factors (13). Blacks with hypertension are more likely than whites with hypertension to develop concentric LVH (13). Women with hypertension are more likely than men with hypertension to develop concentric LVH (13). Increasing age in patients with hypertension is associated with concentric LVH (13). Diabetes mellitus in patients with hypertension is associated with concentric LVH, whereas obesity, which is a volume overload state, and coronary artery disease in patients with hypertension are more likely to be associated with eccentric LVH (13).