Cardioconnection: Hypertension

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February 27, 2016

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High Blood Pressure and Hypertensive Heart Disease

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Hypertensive heart disease is the No. 1 cause of death associated with high blood pressure. It refers to a group of disorders that includes heart failure, ischemic heart disease, hypertensive heart disease, and left ventricular hypertrophy (excessive thickening of the heart muscle).

What Is Heart Failure?

Heart failure does not mean the heart has stopped working. Rather, it means that the heart's pumping power is weaker than normal or the heart has become less elastic. With heart failure, blood moves through the heart's pumping chambers less effectively, and pressure in the heart increases, making it harder for your heart to deliver oxygen and nutrients to your body.

To compensate for reduced pumping power, the heart's chambers respond by stretching to hold more blood. This keeps the blood moving, but over time, the heart muscle walls weaken and are unable to pump as strongly. As a result, the kidneys often respond by causing the body to retain fluid (water) and sodium. The resulting fluid buildup in the arms, legs, ankles, feet, lungs, or other organs, and is called congestive heart failure.

High blood pressure brings on heart failure by causing left ventricular hypertophy, a thickening of the heart muscle that results in less effective muscle relaxation between heart beats. This makes it difficult for the heart to fill with enough blood to supply the body’s organs, especially during exercise, leading your body to hold onto fluids and your heart rate to increase.

Symptoms of heart failure include:

  • Shortness of breath
  • Swelling in the feet, ankles, or abdomen
  • Difficulty sleeping flat in bed
  • Bloating
  • Irregular pulse
  • Nausea
  • Fatigue
  • Greater need to urinate at night

What Is Ischemic Heart Disease?

High blood pressure can also cause ischemic heart disease. This means that the heart muscle isn't getting enough blood. Ischemic heart disease is usually the result of atherosclerosis or hardening of the arteries (coronary artery disease), which impedes blood flow to the heart. Symptoms of ischemic heart disease may include:

  • Chest pain which may radiate (travel) to the arms, back, neck, or jaw
  • Chest pain with nausea, sweating, shortness of breath, and dizziness; these associated symptoms may also occur without chest pain
  • Irregular pulse
  • Fatigue and weakness

Any of these symptoms of ischemic heart disease warrant immediate medical evaluation.