Effects of Hypertension on Heart

The effects of hypertension (high blood pressure) on heart are very profound and hypertension is a risk factor for all clinical manifestations of atherosclerosis. Hypertension is also an independent predisposing factor for heart failure, coronary artery disease (CAD), stroke, renal (kidney) disease, and peripheral arterial disease (PAD).
Causes of changes in the heart due to hypertension:

In a person with hypertension the commonest cause of death is due to heart disease. The heart diseases in a person with hypertension are the result of structural and functional adaptations which leads to hypertrophy left ventricle, diastolic dysfunction, congestive heart failure (CHF), and abnormalities of blood flow due to atherosclerotic changes in the coronary arteries and micro-vascular disease, and cardiac arrhythmias.

Abnormalities of diastolic function in hypertensive persons may be asymptomatic heart disease to overt heart failure. Approximately one-third of patients with CHF (congestive heart failure) have normal systolic function but abnormal diastolic function. Abnormal diastolic function is an early sign of hypertension-related heart disease which is aggravated by left ventricular hypertrophy and ischemia (loss of blood supply in a particular are and cell death). Diastolic function can be evaluated by several noninvasive methods like echocardiography and radionuclide angiography.

Genetic and other factors in hypertensive heart disease:

Both genetic and other (hemodynamic) factors contribute to left ventricular hypertrophy due to hypertension. Left ventricular hypertrophy can be diagnosed by electrocardiogram (ECG), but echocardiography is more sensitive for measuring left ventricular wall thickness as well. Persons with left ventricular hypertrophy are at higher risk for sudden death, CHD (coronary heart disease), stroke, and CHF. Aggressive treatment and control of hypertension can reverse left ventricular hypertrophy and reduce the risk of cardiovascular disease, as well as death due to hypertensive heart disease.