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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Hypertension and Heart Failure: Understanding the Connection
Introduction
Hypertension (high blood pressure) and heart failure (HF) are closely related conditions. Long-term high blood pressure increases the workload on the heart, leading to structural and functional changes that can result in heart failure. Understanding this relationship is crucial for prevention, management, and treatment.
How Hypertension Leads to Heart Failure
- Increased Afterload: Chronic high blood pressure forces the heart to pump against a higher resistance, leading to left ventricular hypertrophy (thickening of the heart muscle).
- Diastolic Dysfunction: A thickened heart muscle makes it harder for the left ventricle to fill properly with blood, leading to heart failure with preserved ejection fraction (HFpEF).
- Systolic Dysfunction: Over time, the strain on the heart can weaken the heart muscle, leading to heart failure with reduced ejection fraction (HFrEF).
- Vascular Changes: Hypertension damages blood vessels, reducing their elasticity and impairing blood flow, which contributes to heart failure progression.
Symptoms Overlap
- Shortness of breath (especially during exertion or while lying down)
- Fatigue and weakness
- Swelling in the legs, ankles, or feet (edema)
- Rapid or irregular heartbeat
- Persistent coughing or wheezing
Diagnosis
Doctors use a combination of methods to diagnose these conditions: - Blood pressure measurements (Hypertension is defined as BP >130/80 mmHg) - Echocardiogram (To assess heart structure and function) - Electrocardiogram (ECG) (To detect electrical abnormalities) - Blood tests (Including BNP or NT-proBNP, which indicate heart stress) - Imaging tests (MRI or CT scan in certain cases)
Treatment Approaches
Lifestyle Modifications (First-line prevention and management):
- Reduce salt intake (<2g/day)
- Maintain a healthy weight
- Engage in regular physical activity (at least 150 minutes per week)
- Manage stress and ensure proper sleep
- Avoid excessive alcohol and smoking
Medications for Both Hypertension and Heart Failure:
- ACE inhibitors/ARBs: Reduce blood pressure and decrease heart strain
- Beta-blockers: Lower heart rate and improve heart function
- Diuretics: Reduce fluid overload and lower blood pressure
- Mineralocorticoid receptor antagonists (e.g., spironolactone): Protect against heart failure progression
- SGLT2 inhibitors: A newer class beneficial in heart failure management
Advanced Treatments for Severe Cases:
- Implantable devices (e.g., pacemaker, defibrillator)
- Surgical options (e.g., heart transplantation in extreme cases)
Conclusion
Hypertension is a major contributor to heart failure, but early intervention can prevent or delay its development. Regular blood pressure monitoring, lifestyle changes, and appropriate medications significantly reduce risks. If you have hypertension, it is important to work closely with a doctor to keep your heart healthy.
Source recommendations
1. 2023 American Heart Association/American College of Cardiology Hypertension Guidelines
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001168
- https://www.acc.org/Latest-in-Cardiology/Articles/2024/02/05/11/43/2023-ESH-Hypertension-Guideline-Update
- https://www.heart.org/en/health-topics/high-blood-pressure
- https://www.acc.org/Guidelines
- https://www.jacc.org/doi/10.1016/j.jacadv.2024.101230
2. 2021 European Society of Cardiology Guidelines for the Treatment of Heart Failure
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
- https://academic.oup.com/eurheartj/article/42/36/3599/6358045
- https://pubmed.ncbi.nlm.nih.gov/34447992/
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines
- https://academic.oup.com/eurheartj/article/44/37/3627/7246292
3. 2018 European Society of Cardiology/European Society of Hypertension Guidelines for the Management of Arterial Hypertension
- https://pubmed.ncbi.nlm.nih.gov/30165516/
- https://academic.oup.com/eurheartj/article/39/33/3021/5079119
- https://pubmed.ncbi.nlm.nih.gov/30234752/
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Elevated-Blood-Pressure-and-Hypertension
- https://www.eshonline.org/esh-content/uploads/2018/10/Download-1.pdf
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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