Hypertensive Heart Disease: Things to know

What is hypertensive heart disease?

Hypertensive heart disease is a long-term condition that develops over many years in people who have high blood pressure. It’s a group of medical problems ― like heart failure and conduction arrhythmias ― that can happen when you don’t control your high blood pressure (hypertension). Chronic high blood pressure (higher than 120/80 mmHg) causes hypertensive heart disease. As people get older and continue to have high blood pressure, their risk of heart disease increases. Heart failure occurs most often in people older than 65. Chronic high blood pressure puts a strain on your heart and makes it harder for it to pump your blood. Your heart muscle can get thick and weak, possibly leading to heart failure. The walls of your blood vessels can also thicken because of high blood pressure, and this becomes more dangerous when cholesterol collects inside the blood vessels. Then your heart attack and stroke risks go up. High blood pressure makes men twice as likely and women three times more likely to get heart failure. However, people who manage their high blood pressure can greatly reduce their risk of heart failure. People who have hypertensive heart disease with heart failure have a higher risk for:

Decompensated heart failure.
Acute coronary syndrome.
Sudden cardiac death.

What are the types of hypertensive heart disease?

High blood pressure makes it more difficult for your heart to push blood through your blood vessels. When plaque collects in your blood vessels or part of your heart muscle gets bigger because of high blood pressure, you can get these problems:

Coronary artery disease.
Left ventricular hypertrophy (enlarged heart).

What are the complications of hypertensive heart disease?

Complications of hypertensive heart disease include:

Heart failure.
Arrhythmia.
Stroke.
Ischemic heart disease.
Sudden cardiac death.

High blood pressure puts people at risk for:

Atrial fibrillation.
Congestive heart failure.
Coronary artery disease.
Atherosclerosis.
Retinal disease.
Peripheral arterial disease.
Chronic kidney disease.
Aortic aneurysm.
Cerebrovascular disease.

How common is hypertensive heart disease?

One out of every three adults in America has high blood pressure, but only half of those with the diagnosis have their blood pressure under control. Hypertensive cardiovascular disease is the number one cause of illness and death due to high blood pressure.

Who is at risk for hypertensive heart disease?

You’re at risk for hypertensive heart disease if you:

Have high blood pressure.
Don’t exercise.
Have diabetes.
Have high cholesterol.
Are older than 45.
Are overweight.
Smoke or use tobacco products.
Eat a high salt diet.
Drink alcohol.

SYMPTOMS AND CAUSES

What causes hypertensive heart disease?

High blood pressure that is not controlled for years causes hypertensive heart disease.

What are the symptoms of hypertensive heart disease?

Because there are no symptoms with high blood pressure, many people don’t know they have it. Symptoms of hypertensive cardiovascular disease often show up after your heart has already been damaged. Symptoms of hypertensive heart disease include:

Chest pain.
Shortness of breath.
Palpitations.
Dizziness.
Fainting.
Stroke.
Sudden cardiac death.

DIAGNOSIS AND TESTS

How is hypertensive heart disease diagnosed?

Since people with high blood pressure don’t have symptoms, it’s important to go to regular appointments with your provider. Your provider will want to get:

Your medical history.
Your family history of heart problems.
A physical exam.

What tests will be done to diagnose hypertensive heart disease?

Your provider will want to rule out other problems that cause heart failure, such as ischemic cardiomyopathy. Tests include:

Blood tests.
Urine test.
Electrocardiogram (EKG).
Echocardiogram for some people.

MANAGEMENT AND TREATMENT

How is hypertensive heart disease treated?

Your provider will treat the medical problems you have, such as:

High blood pressure.
Diabetes.
Obesity.
Lung disease.
Sleep apnea.
Chronic kidney disease.
High cholesterol.

Your provider may ask you to change your lifestyle in these ways:

Stop smoking or using tobacco products.
Drink less alcohol.
Stop using recreational drugs.
Exercise more.
Eat less sodium.
Lose weight.

What medications are used for hypertensive heart disease?

Any medicine can have side effects, but it’s important to keep taking your medicines. If you’re worried about a side effect from your medication, your provider may be able to switch you to a different one. Medicines to treat high blood pressure include:

Diuretics that make your body clear excess fluid out.
Calcium channel blockers that make your blood vessels more open.
Angiotensin-converting enzyme inhibitors that help loosen your blood vessels.
Angiotensin II receptor blockers that help relax your blood vessels.
Vasodilators that help blood vessels get wider.
Renin inhibitors that help loosen up your blood vessels.
Beta blockers that slow down your heart rate and make your heart’s job easier.

How do I manage symptoms with hypertensive heart disease?

There are several things you can do, such as:

Keep taking the medicines your provider ordered.
Get treated for any medical conditions you have.
Make healthier changes to your lifestyle, as noted above.
Keep going to your follow-up medical appointments.

PREVENTION

How can I reduce my risk of hypertensive heart disease?

You can decrease your risk of hypertensive heart disease with lifestyle changes such as:

Exercising.
Staying at a healthy weight.
Eating healthy foods.

Your healthcare provider may order high blood pressure medicines for you such as:

Calcium channel blockers.
Diuretics.
Beta blockers.
ACE inhibitors.
Potassium replacements.

How can I prevent hypertensive heart disease?

Get your blood pressure checked once a year if you’re older than 18. Get readings more often if your numbers are high. If your blood pressure is high, bring it down and keep it down. You can purchase a blood pressure monitor you can use at home. If high blood pressure is found early and treated, it may keep you from getting:

Stroke.
Heart disease.
Chronic kidney disease.
Eye problems.

Other things you can do:

Treat your diabetes.
Treat your high cholesterol.

Frequently Asked Questions:

In order to treat hypertensive heart disease, your doctor has to treat the high blood pressure that is causing it. They will treat it with a variety of drugs, including diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, angiotensin receptor blockers, and vasodilators.

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.

Long-term outlook. Recovering from hypertensive heart disease depends on the exact condition and its intensity. Lifestyle changes can help keep the condition from getting worse in some cases. In severe cases, medications and surgery may not be effective in controlling the disease.

There is no cure for high blood pressure. But treatment can lower blood pressure that is too high. If it is mild, high blood pressure may sometimes be brought under control by making changes to a healthier lifestyle.

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