REN and left ventricular hypertrophy: Thus, chronic activation of the renin-angiotensin-aldosterone system during hypertension may further exacerbate these pathological processes.1–4,28 Also, the hemodynamic effects of hypertension are well known; hypertension increases cardiac afterload, which promotes left ventricular hypertrophy and left ventricular stiffness, decreases ventricular systolic and diastolic function, and increases left atrial pressure.