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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.
Hypertensive Heart Disease with Heart Failure
Introduction
Hypertensive heart disease (HHD) is a condition resulting from prolonged high blood pressure (hypertension), leading to structural and functional changes in the heart. Over time, uncontrolled hypertension can cause the heart to work harder, leading to hypertrophy (thickening of the heart muscle), dysfunction, and ultimately heart failure (HF).
Pathophysiology
When blood pressure remains elevated for years: - The left ventricle (the main pumping chamber of your heart) thickens because it has to work harder. - This thickening (left ventricular hypertrophy, LVH) eventually reduces the heart's ability to relax and fill properly (diastolic dysfunction). - As the disease progresses, the heart may weaken, leading to systolic dysfunction and symptoms of heart failure.
Symptoms
Patients may experience: - Shortness of breath (especially during activity or while lying down) - Swelling in the legs and ankles - Fatigue and weakness - Irregular heartbeat - Chest discomfort
Diagnosis
To diagnose HHD with heart failure, a doctor may recommend: - Blood Pressure Measurements – Essential to confirm hypertension. - Electrocardiogram (ECG) – Can detect left ventricular hypertrophy. - Echocardiography – Assesses heart structure and function. - Blood Tests – To check for heart failure markers like BNP (B-type natriuretic peptide). - Chest X-ray – To evaluate heart size and fluid accumulation.
Treatment
1. Managing Blood Pressure
Lowering blood pressure is critical to slowing disease progression. Common medications include: - ACE inhibitors or ARBs: Reduce blood pressure and heart stress. - Beta-blockers: Improve heart function and lower heart rate. - Diuretics: Help reduce fluid buildup and lower blood pressure. - Calcium channel blockers: Relax blood vessels and improve circulation.
2. Treating Heart Failure
- Lifestyle Changes: Quit smoking, adopt a heart-healthy diet (low sodium, DASH diet), and exercise regularly.
- Medications: In addition to the above, patients may require additional heart failure medications such as mineralocorticoid receptor antagonists or SGLT2 inhibitors.
- Device Therapy: In severe cases, a pacemaker or defibrillator may be needed.
Conclusion
Hypertensive heart disease with heart failure is a serious but manageable condition. Controlling blood pressure, adopting a healthy lifestyle, and adhering to medications are vital in preventing complications and improving quality of life.
References
- Regular follow-ups with a cardiologist are essential.
- Adhering to guideline-recommended therapy significantly improves outcomes.
Source recommendations
1. American College of Cardiology/American Heart Association (ACC/AHA) Guidelines for the Management of Heart Failure
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
- https://www.jacc.org/doi/10.1016/j.jacc.2023.12.024
- https://www.acc.org/education-and-meetings/products-and-resources/features/global-cv-institute/heart-failure-guidelines
- https://professional.heart.org/en/science-news/-/media/832EA0F4E73948848612F228F7FA2D35.ashx
- https://www.acc.org/Guidelines
2. European Society of Cardiology (ESC) Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
- https://pubmed.ncbi.nlm.nih.gov/34447992/
- https://academic.oup.com/eurheartj/article/42/36/3599/6358045
- https://pubmed.ncbi.nlm.nih.gov/22611136/
- https://academic.oup.com/eurheartj/article/44/37/3627/7246292
3. European Society of Hypertension (ESH) and European Society of Cardiology (ESC) Guidelines for the Management of Arterial Hypertension
- https://pubmed.ncbi.nlm.nih.gov/37345492/
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Elevated-Blood-Pressure-and-Hypertension
- https://academic.oup.com/eurheartj/article/39/33/3021/5079119
- https://journals.lww.com/jhypertension/fulltext/2023/12000/2023_esh_guidelines_for_the_management_of_arterial.2.aspx
- https://www.acc.org/Latest-in-Cardiology/Articles/2024/02/05/11/43/2023-ESH-Hypertension-Guideline-Update
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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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