Resistant hypertension and left ventricular hypertrophy: An overview

Cesare Cuspidi, Alvaro Vaccarella, Francesca Negri, Carla Sala

Research output: Contribution to journalArticlepeer-review


Available data on subclinical cardiac damage in resistant hypertension (RH) are rather scanty. Thus, we sought to review the literature focusing on the association between RH and left ventricular hypertrophy (LVH). A MEDLINE search was performed to identify relevant articles using the key words "resistant hypertension, " "refractory hypertension," "left ventricular hypertrophy," "cardiac damage," and "left ventricular dysfunction." Full articles published in the English language in the last two decades (December 1, 1989, to July 31, 2010) reporting studies in adult or elderly individuals, were considered. Checks of the reference lists of selected articles complemented the electronic search. A total of 11 cross-sectional and longitudinal studies, including 3325 patients attending outpatient hypertension clinics, were considered. Prevalence rates of echocardiographic LVH, as assessed by updated criteria, ranged from 55% to 75% of patients with RH, peaking to 91% in the subgroup with concomitant electrocardiographic (ECG) LV strain. Reduction in ECG-LVH induced by treatment showed a relevant beneficial impact on cardiovascular prognosis. These data support the view that initial and on-treatment assessment of LVH in patients with RH is important for cardiovascular risk monitoring and therapeutic strategies decision-making.

Original languageEnglish
Pages (from-to)319-324
Number of pages6
JournalJournal of the American Society of Hypertension
Issue number6
Publication statusPublished - Nov 2010


  • Cardiovascular prognosis
  • Left ventricular hypertrophy
  • Resistant hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine


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