Is it possible to reverse LVH?

Patient's Query

Hi doctor,

My husband is 35 years. Before four years, he has done nasal septoplasty surgery. The doctor told me that he has high blood pressure. After doing all the tests, he was diagnosed with moderate concentric LVH. Initially, my husband was with a weight of 98 kilograms and a height of five feet six inches. After taking hypertensive medicines with diet and exercise, he has a weight of 79 kilograms now. He visits cardiologist every three months. In the ECG taken last year, he had a diagnosis of sinus arrhythmia, prolonged P-wave, and complete right bundle branch block. He had normal valves with normal LV systolic function. The doctor has advised him to continue taking medicines, diet, and exercise. What do you interpret from ECG and echo test? Is it fine to continue taking hypertensive medications with diet and exercise? His blood pressure is under control now. Will LVH be reversed?

Answered by Dr. Sagar Ramesh Makode

Hi,

Welcome to icliniq.com.

I have gone through the reports (attachment removed to protect patient identity). He has hypertension and he needs medication for the long term. It is good to have weight loss by following a healthy lifestyle. He needs to avoid taking fatty, oily, and high-calorie food. Give him plenty of green leafy vegetables and fruits. His requirement for anti-hypertensive has gone down now. So his future blood pressure readings have to be followed. For now, he needs to take blood pressure medications regularly with regular blood pressure monitoring. Usually, blood pressure should be around 110 mmHg to 130 mmHg systolic and less than 90 mmHg diastolic.

Regarding ECG (electrocardiogram) and ECHO (echocardiogram), they show hypertensive changes and there is nothing to be worried. Concentric LVH (left ventricular hypertrophy) will be there even if his blood pressure is under control and it does not cause any problems. ECG does not show complete RBBB (right bundle branch block). But there are early RBBB changes and it is likely related to hypertension. Sinus arrhythmia is a normal finding and there is nothing to be worried about prolonged P-wave. There are changes that are not significant and alarming. So he needs to focus on blood pressure. He needs to lead a healthy lifestyle. He needs to do a lipid profile and treadmill test after 40 years of age.

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