We know LVH and SHT go together . Mind you , this is not an Intimate relationship.
Widespread utilisation of echocardiography has revealed , definite LVH occurs only in about 20% (A guess !) of HT . (Do you know in the Famingham study the incidence of LVH after 12 year follow up was a paltry 3 % .Will you agree with that ? Mind you , It was in 1969 when Echo was not there )
What determines LVH ? The clear answer is elusive. It is easy to escape from the issue by calling it multi factorial !
Why don’t you try this question .
My guess would be , magnitude ( or even duration of HT !) is less important than genetic predisposition or associated diabetes , renal involvement.Our analysis from hypertension clinic reveals LVH is many fold common in secondary HT when compared to primary HT !
I often used to provoke the students by saying if the LVH is gross in HT it can not be primary , 9/10 times ! Invariably we find some other association or reason for the HT !
Link to related topic in this site
Why-lvh-does-not-occur-in-all-patients-with-systemic-hypertension ?
How-diabetes-modifies-lvh-due-to-hypertension ?
Next . . .
How does LVH regress with treatment ?
Dr.S.Venkatesan MD 
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