Diagnosing left ventricular hypertrophy in arterial hypertension

Arterial hypertension is an important public health challenge—it affects almost one third of the adult population in economically developed countries and is a major contributor of cardiovascular mortality and morbidity. The management of primary hypertension is based on three important principles—diagnosis, treatment, and identifying organ disease and indicators of subclinical organ damage.

In this week's BMJ, a systematic review by Pewsner and colleagues assesses the accuracy of electrocardiography in screening for left ventricular hypertrophy in people with hypertension.1 It finds that electrocardiography has a low sensitivity for detecting left ventricular hypertrophy compared with echocardiography.

Treatment aims for a target blood pressure below 140/90 mm Hg in the general population2 and below 130/80 mm Hg in patients with diabetes and renal dysfunction. A target of ≤130/80 mm Hg should also be considered in patients with cerebrovascular disease, cardiac disease, peripheral artery disease, and advanced retinopathy. Such a target is also advisable …