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Hypertensive heart disease

Definition

Hypertensive heart disease refers to heart problems that occur because of high blood pressure that is present over a long time.

Alternative Names

Hypertension - hypertensive heart; High blood pressure - hypertensive heart

Causes

High blood pressure means the pressure inside the blood vessels (called arteries) is too high. As the heart pumps against this pressure, it must work harder. Over time, this causes the heart muscle to thicken.

Because there are often no symptoms with high blood pressure, people can have the problem without knowing it. Symptoms most often do not occur until after many years of poor blood pressure control, when damage to the heart has occurred.

Eventually, the muscle may become so thick that it does not get enough oxygen. This can cause angina (chest pain). Without appropriate blood pressure control, the heart can weaken over time and heart failure may develop.

High blood pressure also leads to thickening of the blood vessel walls. When combined with cholesterol deposits in the blood vessels, the risk of heart attack and stroke increases.

Hypertensive heart disease is the leading cause of illness and death from high blood pressure.

When to Contact a Medical Professional

Call your health care provider if you have high blood pressure and develop any symptoms.

Prevention

Diagnosing high blood pressure early can help prevent heart disease, stroke, eye problems, and chronic kidney disease.

All adults over the age of 18 should have their blood pressure checked every year. More frequent measurement may be needed for those with a history of high blood pressure readings or those with risk factors for high blood pressure.

Guidelines can change as new information becomes available, Therefore, your health care provider may recommend more frequent screenings based on your blood pressure levels and other health conditions.

If your blood pressure is high, you need to lower it and keep it under control.

  • Do not stop or change high blood pressure medicines without talking to your provider.
  • Carefully control diabetes and high cholesterol.

References

Rogers JG, O'Connor CM. Heart failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 52.

Siu AL, US Preventive Services Task Force. Screening for high blood pressure in adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(10):778-786. PMID: 26458123 pubmed.ncbi.nlm.nih.gov/26458123/.

Victor RG. Arterial hypertension. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 70.

Victor RG. Systemic hypertension mechanisms and diagnosis. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 46.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.


Review Date: 1/27/2020
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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