Generally speaking hypertension leads to compensatory changes in myocardial hypertrophy, and early aggressive treatment, such as controlling blood pressure with ACEI (prilosec) or ARB (sartan) can alleviate, or even reverse, myocardial hypertrophy; later in life when the myocardium loses compensation it tends to cause centrifugal hypertrophy, at which point most of it is irreversible.