Editorial comment--Left ventricular hypertrophy: an unseemly risk factor for stroke?

Left ventricular hypertrophy (LVH) has been increasingly recognized in the last decade as a risk factor for cardiovascular disease and stroke. However, at least in this guest editor’s experience, LVH is seldom or never mentioned, in everyday practice, among the risk factors considered relevant in a patient with cerebrovascular disease, whether because it is forgotten, neglected, or even despised. Why is this so? LVH is usually considered a consequence of arterial hypertension: the left ventricle increases its mass and wall thickness to oppose a rise in the pressure load. Patients with LVH whose blood pressure is normal are thought to be “probably hypertensive,” albeit with “nonsustained hypertension.” In this line of reasoning, the relevant risk factor is hypertension and not the “secondary” consequence of LVH. In other instances, LVH is dismissed as a phenomenon linked to “aging,” akin to the …