Hypertensive heart disease

What is Hypertensive heart disease?

Hypertensive heart disease refers to heart conditions that develop as a result of hypertension (high blood pressure). Ten percent of individuals with chronic hypertension have enlarged left ventricles (left ventricular hypertrophy) with a seven-fold risk of morbidity and mortality due to congestive heart failure, disturbances of heart rhythms (ventricular arrhythmias), and heart attack (myocardial infarction).

For these reasons, an enlarged left ventricle in association with hypertension is considered the definitive sign of hypertensive heart disease. Though an enlarged ventricle indicates that heart disease is present, early treatment can prevent future serious heart complications. Fortunately, most individuals respond well to drug therapy, which usually results in a reduction of the size of the left ventricle. Most cases of hypertension have no discernible cause. This is called essential hypertension. It is a chronic, treatable disease, but there is no cure.

How is it diagnosed?

History: Individuals with hypertensive heart disease may have symptoms coronary artery disease (angina), fatigue, and shortness of breath with exertion and/or at rest. Congestive heart failure can include episodes of interrupted sleep due to breathing problems (paroxysmal nocturnal dyspnea).

Physical exam: Hypertension in varying degrees of severity is present. There are changes in the small blood vessels (arterioles) noted during examination of the eyes. There may be an irregular pulse. Auscultation of the heart can reveal an irregular pulse, murmurs, and extra heart sounds (gallops). In advanced cases of hypertensive heart disease, the individual may have an enlarged liver and swelling of the feet and ankles among other signs of congestive heart failure.

Tests: An electrocardiogram, echocardiogram and chest x-ray will confirm the presence of an enlarged left ventricle.

How is Hypertensive heart disease treated?

Individuals are treated with to drug therapy that typically includes diuretics and beta-blockers. Individuals with signs of cardiovascular disease are advised to reduce salt and alcohol in the diet, abstain from smoking, lose weight, and exercise regularly.

Medications

Information	Brand	Generic	Label	Rating
	Lipitor	Atorvastatin

Zocor (Simvastatin), Actos (Pioglitazone), Avandia (Rosiglitazone)

What might complicate it?

Coronary artery disease and alcohol abuse increase the individual's risk for developing serious cardiovascular disease.

Predicted outcome

Drug therapy that reduces the blood pressure is usually also successful in reducing the ventricular enlargement and alleviating the symptoms.

Alternatives

Left ventricular hypertrophy may be secondary to stenosis of the aortic valve or idiopathic hypertrophic subaortic stenosis.

Appropriate specialists

Cardiologist.

Last updated 20 May 2015