What is a general management principle for left ventricular hypertrophy due to hypertension?

• A. Lifestyle modifications and BP-lowering medications (BBs/ACE inhibitors/ARBs/CCBs) with diuretics for volume overload
• B. Surgical therapy
• C. High-sodium diet
• D. No treatment

Answer: (A)

The key idea is that left ventricular hypertrophy from long-standing hypertension is best managed by lowering blood pressure and reducing volume overload through a combination of lifestyle changes and antihypertensive medications. By decreasing afterload, the heart doesn’t have to work as hard, and over time the hypertrophy can regress, improving symptoms and reducing cardiovascular risk. This approach includes practical steps like weight management, regular exercise, sodium reduction, and other diet changes, along with medications that lower blood pressure. Agents that affect the renin–angiotensin system (ACE inhibitors or ARBs), calcium channel blockers, and sometimes beta-blockers are used to control pressure, with diuretics added if there is volume overload. The other options aren’t appropriate general management: surgery isn’t a typical first-line approach for hypertensive LVH, a high-sodium diet would worsen blood pressure, and doing nothing allows the hypertrophy and its risks to persist.