Hypertensive heart disease
Hypertension - hypertensive heart; High blood pressure - hypertensive heart
Hypertensive heart disease refers to heart problems that occur because of high blood pressure that is present over a long time.
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 muscle 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.
Carrying a lot of extra weight around your middle or sprinkling too much salt onto your food at each meal can cause high blood pressure, otherwise known as hypertension. Stress and your genes can also bring your blood pressure up. Sometimes when your blood pressure is high, your doctor might not be able to find any direct cause for it. That's what's called essential hypertension. When your doctor talks to you about your blood pressure, he's referring to the force of your blood pushing against your artery walls. The top number in your blood pressure is called the systolic blood pressure. That's the pressure in your blood vessels while your heart is pumping. The bottom number is called the diastolic blood pressure and that's the pressure when your heart rests between beats. You want your blood pressure to stay at 120 over 80 or less. A blood pressure of 140 over 90 or more is considered high. Why is high blood pressure a problem, you ask? Well, you can think of high blood pressure as being like a river that's rushing too hard, eventually it's going to damage its banks. With high blood pressure, the extra force of your blood pushing against your artery walls eventually damages them. It can also damage your heart, your kidneys, and other organs. So, how do you know if you have high blood pressure? Often you don't know, because high blood pressure doesn't have symptoms like a fever or cough. Usually there are no symptoms at all, and you won't be able to find out that you have high blood pressure unless you've had it checked, or you've developed complications like heart disease or kidney problems. You can check your blood pressure yourself with a home monitor, or have it checked at your doctor's office. If it's high, you and your doctor will set a blood pressure goal. You can achieve that goal in different ways, like eating a healthy diet, exercising for at least 30 minutes a day, quitting smoking, eating less than 1,500 milligrams of salt per day, and using programs like meditation and yoga to relieve your stress. But if these lifestyle changes aren't enough, your health care provider might prescribe one or more medicines to lower your blood pressure. The reason why doctors are so serious about a patients' blood pressure is that having uncontrolled blood pressure can cause a lot of serious health problems, including heart attack, stroke, kidney disease, and loss of vision. When it comes to your blood pressure, it's best to be proactive. Call your doctor for a check-up if you haven't had one in a while, and get your blood pressure checked. If it's high, follow your doctor's advice for bringing it back into a healthy range.
When to Contact a Medical Professional
Contact 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 people age 18 and older 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 provider may recommend more frequent checks 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
Bakris GL, Sorrentino MJ. Systemic hypertension: mechanisms, diagnosis, and treatment. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 26.
Flack JM. Arterial hypertension. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 64.
Rogers JG, O'Connor CM. Heart failure: epidemiology, pathobiology, and diagnosis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 45.
US Preventive Services Task Force, Krist AH, Davidson KW, et al. Screening for Hypertension in Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA. 2021;325(16):1650-1656. PMID: 33904861
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
Version Info
Last reviewed on: 2/27/2024
Reviewed by: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
