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See related article, p 518–525 Hypertension, kidney disease, and enlarged hearts have been intertwined since Richard Bright’s observations in the early 19th century.1 In recent decades, a sequence of epidemiological surveys have revealed that the black population is disproportionately burdened by hypertension, left ventricular hypertrophy (LVH), and chronic progressive renal disease progressing to death, stroke, heart failure, and end-stage renal disease that requires renal replacement therapy, most often dialysis. Once clinical trials established the importance of reducing arterial pressure to prevent both fatal and nonfatal cardiovascular disease and progression of chronic kidney disease, it became imperative to define optimal antihypertensive drug therapy for the many blacks at risk for these diseases. Could any effective antihypertensive drug class do the job? Or would any 1 class, for example, angiotensin-converting enzyme inhibitors, be superior for reducing the disastrously high rate of fatal and nonfatal disease in blacks with hypertensive chronic renal disease, so many of whom had enlarged hearts (LVH) …

AASK Why Is Left Ventricular Hypertrophy So Deleterious?