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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:
- Thiazide diuretics act on your kidneys to help your body eliminate sodium and water, thereby reducing blood volume. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications.
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Angiotensin-converting enzyme (ACE) inhibitors are a type of drug that widens, or dilates, 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.
- 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), nifedipine (Procardia) and verapamil (Calan, Verelan, Covera-HS).
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 human-cadaver donor. If you have aortic valve regurgitation, the leaky valve may be surgically repaired or replaced.
- Kaplan NM, et al. Clinical implications and treatment of left ventricular hypertrophy in hypertension. http://www.uptodate.com/home/index.html. Accessed Feb. 4, 2010.
- Maron BJ. Hypertrophic cardiomyopathy. In: Libby P, et al., eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-4106-1..50068-6--cesec3&displayedEid=4-u1.0-B978-1-4160-4106-1..50068-6--cesec4&uniq=181218300&isbn=978-1-4160-4106-1&sid=946756953. Accessed Feb. 4, 2010.
- Atrial and ventricular enlargement. In: Goldberger Ary L. Clinical Electrocardiography: A Simplified Approach. Philadelphia, Pa.: Mosby Elsevier; 2006. http://www.mdconsult.com/das/book/body/181218300-7/0/1394/36.html?tocnode=51851133&fromURL=36.html#4-u1.0-B0-323-04038-1..50007-X--cesec4_66. Accessed Feb. 4, 2010.
- Goldberger AL. Electrocardiographic diagnosis of left ventricular hypertrophy. http://www.uptodate.com/home/index.html. Accessed Feb. 4, 2010.
- Murashima M, et al. Hypertension. In: Rakel RE, et al. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-6642-2..00005-3--s0325&displayedEid=4-u1.0-B978-1-4160-6642-2..00005-3--s0330&uniq=181218300&isbn=978-1-4160-6642-2&sid=946716787#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-1-4160-6642-2..00005-3--sc0070%3Bfrom%3Dtoc%3Btype%3DbookPage%3Bisbn%3D978-1-4160-6642-2. Accessed Feb. 4, 2010.
- Domino FJ. Overview of hypertension in adults. http://www.uptodate.com/home/index.html. Accessed Feb. 4, 2010.
- Aortic valve stenosis (AS) and aortic insufficiency (AI). American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=1659. Accessed Feb. 4, 2010.
- Cannon CP, et al. Approach to the patient with chest pain. In: Libby P, et al., eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-4106-1..50052-2&uniq=159657875&isbn=978-1-4160-4106-1&sid=887271424. Accessed Feb. 4, 2010.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 16, 2010.
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