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If you have high blood pressure, this means that your heart has to work harder to push blood round your body. To cope with this extra effort, your heart muscles become thicker and stiffer, which can make the heart become enlarged.
An enlarged heart will not pump as well as it should, and this can cause you problems. In particular, an enlarged heart is a common cause of heart failure.
What is "left ventricular hypertrophy" (LVH)?
The right and left sides of your heart do different jobs. The right side takes in blood that has travelled round the body and pumps it to the lungs. From here, the blood enters the left side of the heart from where it is pumped all round your body.
Because the left side of the heart has to work harder to get blood round your body, it is usually this side that becomes enlarged when your blood pressure is too high. This is sometimes called "left ventricular hypertrophy" or "LVH" for short. In other words, it is another name for an enlarged heart.
Is an enlarged heart serious?
People with high blood pressure and an enlarged left side of the heart have four times the risk of a heart attack than someone with the same blood pressure but a normal-sized heart.
Similarly, people with thickened left heart muscles have 12 times the risk of a stroke, and are more likely to have irregular heartbeats (arrhythmias).
How is it detected?
If your doctor thinks you may have an enlarged heart muscle, they may suggest that you have an electrocardiogram (ECG) to check if your heart is working properly. This test measures electrical signals in the heart, and can detect areas of thickened muscle.
If the results of the ECG are not clear, other tests such as an echocardiogram or X-ray can produce images of your heart to check for any enlargement.
Can an enlarged heart be treated?
An enlarged heart can be treated and, for some people, it is possible to reduce the enlarged area over time.
Many of the medicines used to treat high blood pressure will also reduce heart muscle size if it is enlarged. In particular, ACE inhibitors and angiotensin receptor blockers can be very effective.