Hypertension and ECG: What You Need to Know

Introduction

Hypertension (high blood pressure) is a common but serious condition that increases the risk of heart disease, stroke, and other cardiovascular problems. One important tool used to assess the impact of hypertension on the heart is the electrocardiogram (ECG). Let’s explore how hypertension affects the heart and what an ECG can reveal.

Effects of Hypertension on the Heart

When blood pressure remains high over time, it puts extra strain on the heart. This can lead to: - Left Ventricular Hypertrophy (LVH): The heart muscle thickens as it works harder to pump blood, which can be seen on an ECG. - Arrhythmias: High blood pressure increases the risk of irregular heart rhythms, including atrial fibrillation. - Ischemic Changes: Reduced blood flow to the heart can cause ECG abnormalities, such as ST-segment depression.

How an ECG Helps Identify Hypertension-related Issues

An ECG can provide important information about hypertensive heart disease: - Increased Voltage: A sign of myocardial thickening (suggestive of LVH). - ST-T Wave Changes: Can indicate strain on the heart due to long-term high blood pressure. - Atrial Enlargement: Hypertension can cause enlargement of the left atrium, which may appear on an ECG.

Next Steps for Patients

If your doctor suspects hypertension-related heart changes based on an ECG, you may need additional tests such as an echocardiogram or ambulatory blood pressure monitoring. Proper blood pressure management through medication and lifestyle changes is crucial to prevent complications.

Conclusion

Regular ECGs can help detect heart changes due to hypertension early. If you have high blood pressure, follow your doctor’s recommendations for lifestyle changes, medication, and regular monitoring to protect your heart health.

Source recommendations

1. 2023 ESC Guidelines on Hypertension

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Elevated-Blood-Pressure-and-Hypertension
  2. https://pubmed.ncbi.nlm.nih.gov/37345492/
  3. https://www.portailvasculaire.fr/sites/default/files/docs/2023_esh_guidelines_for_the_management_of_arterial.271_0.pdf
  4. https://www.acc.org/Latest-in-Cardiology/Articles/2024/02/05/11/43/2023-ESH-Hypertension-Guideline-Update
  5. https://journals.lww.com/jhypertension/fulltext/2023/12000/2023_esh_guidelines_for_the_management_of_arterial.2.aspx

2. 2020 International Society of Hypertension Global Hypertension Practice Guidelines

  1. https://pubmed.ncbi.nlm.nih.gov/32370572/
  2. https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.15026
  3. https://www.sciencedirect.com/science/article/pii/S0953620520303460
  4. https://ish-world.com/global-hypertension-practice-guidelines
  5. https://www.nature.com/articles/s41440-021-00649-7

3. 2020 AHA/ACC Guidelines for the Management of Hypertension

  1. https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.15026
  2. https://www.sciencedirect.com/science/article/pii/S1050173819300684
  3. https://www.ahajournals.org/doi/10.1161/hyp.0000000000000065
  4. https://www.acc.org/Latest-in-Cardiology/Articles/2024/02/05/11/43/2023-ESH-Hypertension-Guideline-Update
  5. https://www.heart.org/-/media/Files/Professional/Quality-Improvement/Pain-Management/AHA-GUIDELINEDRIVEN-MANAGEMENT-OF-HYPERTENSION--AN-EVIDENCEBASED-UPDATE.pdf

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