In many cases there is no cause found for elevated or high blood pressure. In fact, essential hypertension (also called primary hypertension or idiopathic hypertension) is the most common type of hypertension, affecting 95% of hypertensive patients.
There are a lot of medicins with different working principles to lower bp.
Losartan is an angiotensin II receptor antagonist. It keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.
Spironolactone is a potassium-sparing diuretic.
There are many different bp lowering medicins with diffent working principles like ACE inhibitors, betablockers, angiotensin receptor blockers, Calcium Channel Blockers.
There are even more medication types that can lower blood pressure. Some of these are alpha blockers, vasodilators, and central alpha agonists.
In my experience sometimes your doctor has to experiment a little to find out what medicin (combi) works best for you. This can be a frustrating and time consuming process especially because every time you change medication, it takes a few weeks to settle in.
No, the LVH does not cause high bp. It probably is caused by the high bp.
Some people have hypertension all their life and never develop heart problems. In your case, as your heart seems to be adapting to the bp it is imo important to lower the bp to get the left ventricle to normal proportions again.
I hope this helps you a little. Please note that there is also a high blood pressure community on Medhelp