- The Washington Times - Tuesday, November 16, 2004

CHICAGO (AP) — Aggressively lowering blood pressure isn’t enough to prevent heart attacks and strokes in some patients, and now researchers think they know one reason: enlargement of the heart’s main pumping chamber.

The condition is called left ventricular hypertrophy, or LVH, and affects at least 20 percent of Americans with high blood pressure, or as many as 12 million people.

Two studies found that reducing LVH with blood-pressure drugs can further lower the risk of deadly heart trouble in patients whose blood pressure has been substantially reduced.

“We’ve always known that lowering blood pressure alone in hypertensive patients did not completely reduce the increased risks,” said Dr. Peter Okin of Weill Cornell Medical College in New York. “The question was why.”

The findings confirm doctors’ suspicions that persistent LVH is at least partly to blame, said Dr. Okin, who led one of the studies. Another Weill Cornell researcher, Dr. Richard Devereux, led the other. Both appear in today’s Journal of the American Medical Association (JAMA).

LVH often is not regarded as a standard risk factor for heart attacks and strokes — partly because, until now, relatively little data showed that reversing LVH could make a difference, a JAMA editorial said.

Hypertension is the most common cause of LVH, and Dr. Okin said all patients with high blood pressure probably should be tested for LVH periodically throughout treatment — something many doctors do not do routinely, he said.

But American Heart Association spokesman Dr. Daniel Jones contended that the independent effects of reducing LVH were small in the two studies, and reducing patients’ blood pressure should remain the top priority.

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