Left ventricular hypertrophy (LVH) is the most common hypertension-related cardiac disorder. Indeed, it is present in about 50% of patients with hypertension when examined by echocardiography and up to 20-30% when examined by electrocardiogram (ECG). The presence of LVH may be related to safety concerns when treating hypertension because data from large outcome trials in middle-aged and older patients have shown increased mortality if systolic blood pressure (BP) is lowered <130 mmHg. LVH is only briefly mentioned in the 2024 ESC Hypertension Guideline and in the 2025 AHA/ACC Hypertension Guideline.
