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.

      Without treatment of high blood pressure, symptoms of heart failure may develop. Sometimes, the muscle can be so thick that it does not get enough oxygen. This can cause angina (chest pain).

      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 (aged 18 years and older) should have their blood pressure checked:

      • Once a year for adults age 40 years and older
      • Once a year for people at increased risk for high blood pressure
      • Every 3 to 5 years, adults ages 18 to 39 years with blood pressure less than 130/85 who do not have other risk factors.

      People with high-normal blood pressure (130-139/85-89 mm Hg) who may be at increased risk are those who are overweight or obese, and African Americans.

      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
    • O'Connor CM, Rogers JG. Heart failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 58.

      Siu AL, the U.S. Preventive Services Task Force. Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163:778-786. PMID: 26458123

      Victor RG. Arterial hypertension. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 67.

      Victor RG. Systemic hypertension mechanisms and diagnosis. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 43.