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Treatments and drugs
By Mayo Clinic staffTreatment for left ventricular hypertrophy focuses on the underlying cause of the condition. Depending on the cause, treatment may involve medication or surgery.
Treating high blood pressure
Treatment for high blood pressure usually includes both medications and lifestyle changes, such as regular exercise; a low-sodium, low-fat diet; and no smoking.
In addition to lowering blood pressure, some high blood pressure drugs may prevent further enlargement of left ventricle muscle tissue and may even shrink your hypertrophic muscles. Blood pressure drugs that may reverse muscle growth include the following:
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Angiotensin-converting enzyme (ACE) inhibitors widen, or dilate, blood vessels to lower blood pressure, improve blood flow and decrease the workload on the heart. Examples include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and captopril (Capoten).
ACE inhibitors cause an irritating cough in some people. It may be best to put up with the cough, if you can, to gain the medication's benefits. Discuss this side effect with your doctor. Switching to another ACE inhibitor or an angiotensin II receptor blocker may help.
- Angiotensin II receptor blockers (ARBs), which include losartan (Cozaar) and valsartan (Diovan), have many of the beneficial effects of ACE inhibitors, but they don't cause a persistent cough. They may be an alternative for people who can't tolerate ACE inhibitors.
- Thiazide diuretics act on your kidneys to help your body eliminate sodium and water, thereby reducing blood volume.
- Beta blockers slow your heart rate, reduce blood pressure and prevent some of the harmful effects of stress hormones. These drugs include atenolol (Tenormin), carvedilol (Coreg), metoprolol (Toprol XL) and bisoprolol (Zebeta).
- Calcium channel blockers prevent calcium from entering cells of the heart and blood vessel walls. This lowers blood pressure. These drugs include amlodipine (Norvasc), diltiazem (Cardizem, Dilacor XR, Tiazac), nifedipine (Procardia) and verapamil (Calan, Verelan, Covera-HS).
Treating sleep apnea
If you've already been diagnosed with sleep apnea, treating this sleep disorder can help shrink left ventricular hypertrophy. If you haven't been diagnosed with sleep apnea, but your partner tells you that you snore or that you stop breathing momentarily while you sleep, talk with your doctor about getting tested for sleep apnea. Treatment for sleep apnea involves using a machine that provides continuous positive airway pressure (CPAP) while you sleep. This keeps your airways open, allowing you to get the oxygen you need to keep your blood pressure at a normal level.
Aortic valve repair or replacement
If left ventricular hypertrophy is caused by aortic valve stenosis, you may have surgery to remove the narrow valve and replace it with either an artificial valve or a tissue valve from a pig, cow or deceased human donor. If you have aortic valve regurgitation, the leaky valve may be surgically repaired or replaced.
Cholesterol-lowering medications
Although they are not a treatment specifically for left ventricular hypertrophy, the cholesterol-lowering medications known as statins may help treat left ventricular hypertrophy. Clinical trials are currently being done to see if statins are a useful treatment for this disorder.
- Douglas PS, et al. Definition and pathogenesis of left ventricular hypertrophy in hypertension. http://www.uptodate.com/index. Accessed May 28, 2012.
- Kaplan NM, et al. Clinical implications and treatment of left ventricular hypertrophy in hypertension. http://www.uptodate.com/ index. Accessed May 28, 2012.
- Katholi RE, et al. Left ventricular hypertrophy: Major risk factor in patients with hypertension — Update and practical clinical applications. International Journal of Hypertension. 2011;495349:1.
- Lorell BH, et al. Left ventricular hypertrophy: Pathogenesis, detection, and prognosis. Circulation. 2000;102:470.
- Rawlins J, et al. Left ventricular hypertrophy in athletes. European Journal of Echocardiography. 2009;10:350.
- Artham SM, et al. Clinical impact of left ventricular hypertrophy and implications for regression. Progress in Cardiovascular Diseases. 2009;52:153.
- What is high blood pressure? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/. Accessed May 30, 2012.
- Aortic valve stenosis (AS) and aortic insufficiency (AI). American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Aortic-Valve-Stenosis-AVS_UCM_307020_Article.jsp. Accessed May 30, 2012.
- Gersh BJ, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124:e783.
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