Monday, June 15, 2015

Hypertensive heart disease

Hypertension is a powerful predictor of cardiovascular mortality and death from all causes. It is a major risk factor for the development of systolic heart failure as well as heart failure in the setting of preserved left ventricular function.

Hypertensive heart disease can be defined as the response of the heart to the afterload imposed on the left ventricle by the progressively increasing arterial pressure and total peripheral resistance.

Severe hypertension may directly damage arterioles and cause atherosclerosis. High blood pressure is also a risk for stroke.

The risk of cardiovascular events is increased two or three times in men and women with hypertension. It is estimated that 14% deaths from coronary heart disease in men and 12% of deaths from coronary heart disease in women are due to hypertension.

Hypertensive heart disease is characterized by increased left ventricular mass leading to left ventricular hypertrophy in the absence of aortic stenosis or hypertrophic cardiomyopathy. Other manifestations include diastolic dysfunction and microvascular changes that cause coronary blood flow abnormalities.

Left ventricular hypertrophy increases the rletaove risk for amrtlaity by twofold in subjects with coronary artery disease and by four fold in those with normal epicardial coronary arteries.

In the development of hypertensive heart disease, myocyte hypertrophy is also associated with apoptosis, collagen deposition, a ventricular fibrosis, with as impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left ventricle.
Hypertensive heart disease

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