Hypertensive heart disease

Hypertensive heart disease


Hypertensive heart disease includes a number
of complications of systemic arterial hypertension or high blood pressure that affect the heart. While there are several definitions of hypertensive
heart disease in the medical literature, the term is most widely used in the context of
the International Classification of Diseases coding categories. The definition in the Tenth Revision of the
International Classification of Diseases includes heart failure and other cardiac complications
of hypertension when a causal relationship between the heart disease and hypertension
is stated or implied on the death certificate. According to ICD-10, hypertensive heart disease,
and its subcategories: hypertensive heart disease with heart failure and hypertensive
heart disease without heart failure are distinguished from chronic rheumatic heart diseases, other
forms of heart disease and ischemic heart diseases. However, since high blood pressure is a risk
factor for atherosclerosis and ischemic heart disease, death rates from hypertensive heart
disease provide an incomplete measure of the burden of disease due to high blood pressure. Symptoms and signs
The symptoms and signs of hypertensive heart disease will depend on whether or not it is
accompanied by heart failure. In the absence of heart failure, hypertension,
with or without enlargement of the heart is usually symptomless. Symptoms and signs of chronic heart failure
can include: Fatigue
Irregular pulse or palpitations Swelling of feet and ankles
Weight gain Nausea
Shortness of breath Difficulty sleeping flat in bed
Bloating and abdominal pain Greater need to urinate at night
Altered mentation An enlarged heart
Patients can present acutely with heart failure and pulmonary edema due to sudden failure
of pump function of the heart. Acute heart failure can be precipitated by
a variety of causes including myocardial ischemia, marked increases in blood pressure, or cardiac
dysrhythmias, especially atrial fibrillation. Alternatively heart failure can develop insidiously
over time. Stages
Stages of Elevated BP and Hypertension According to The Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Associated conditions Left ventricular hypertrophy and left ventricular
remodeling Diminished coronary flow reserve and silent
myocardial ischemia Coronary heart disease and accelerated atherosclerosis
Congestive heart failure, including Heart Failure With Normal Left Ventricular Ejection
Fraction, often termed diastolic heart failure Atrial fibrillation, other cardiac arrhythmias
and sudden cardiac death Differential diagnosis
Other conditions can share features with hypertensive heart disease and need to be considered in
the differential diagnosis. For example:
Coronary artery disease or ischemic heart disease due to atherosclerosis
Hypertrophic cardiomyopathy Left ventricular hypertrophy in athletes
Congestive heart failure or heart failure with normal ejection fraction due to other
causes Atrial fibrillation or other disorders of
cardiac rhythm due to other causes Sleep apnea
Treatment The medical care of patients with hypertensive
heart disease falls under 2 categories— Treatment of the elevated BP
Prevention and treatment of hypertensive heart disease. Prevention
Because there are no symptoms with high blood pressure, people can have the condition without
knowing it. Diagnosing high blood pressure early can help
prevent heart disease, stroke, eye problems, and chronic kidney disease. The risk of cardiovascular disease and death
can be reduced by lifestyle modifications, including dietary advice, promotion of weight
loss and regular aerobic exercise, moderation of alcohol intake and cessation of smoking. Drug treatment may also be needed to control
the hypertension and reduce the risk of cardiovascular disease, manage the heart failure, or control
cardiac arrhythmias. Patients with hypertensive heart disease should
avoid taking over the counter non-steroidal anti-inflammatory drugs, or cough suppressants,
and decongestants containing sympathomimetics, unless otherwise advised by their physician
as these can exacerbate hypertension and heart failure. Blood Pressure Goals
According to JNC 7, BP goals should be as follows :
Less than 140/90mm Hg in patients with uncomplicated hypertension
Less than 130/85mm Hg in patients with diabetes and those with renal disease with less than
1g/24-hour proteinuria Less than 125/75mm Hg in patients with renal
disease and more than 1 g/24-hour proteinuria Epidemiology Hypertension or high blood pressure affects
at least 1 billion people worldwide. Hypertensive heart disease is only one of
several diseases attributable to high blood pressure. Other diseases caused by high blood pressure
include ischemic heart disease, stroke, peripheral arterial disease, aneurysms and kidney disease. Hypertension increases the risk of heart failure
by two or three-fold and probably accounts for about 25% of all cases of heart failure. In addition, hypertension precedes heart failure
in 90% of cases, and the majority of heart failure in the elderly may be attributable
to hypertension. Hypertensive heart disease was estimated to
be responsible for 1.0 million deaths worldwide in 2004, and was ranked 13th in the leading
global causes of death for all ages. A world map shows the estimated disability-adjusted
life years per 100,000 inhabitants lost due to hypertensive heart disease in 2004. Gender differences in hypertensive heart disease
There are more women than men with hypertension, and, although men develop hypertension earlier
in life, hypertension in women is less well controlled. The consequences of high blood pressure in
women are a major public health problem and hypertension is a more important contributory
factor in heart attacks in women than men. Until recently women have been under-represented
in clinical trials in hypertension and heart failure. Nevertheless, there is some evidence that
the effectiveness of antihypertensive drugs differs between men and women and that treatment
for heart failure may be less effective in women. Ethnic disparities in hypertensive heart disease
Studies in the USA indicate that a disproportionate number of African Americans have hypertension
compared with non-Hispanic whites and Mexican Americans, and that they suffer a greater
burden of hypertensive heart disease. Heart failure is more common in people of
African American ethnicity, mortality from heart failure is also consistently higher
than in white patients, and it develops at an earlier age. Worryingly, recent data suggests that rates
of hypertension are increasing more rapidly in African Americans than other ethnic groups. The excess of high blood pressure and its
consequences in African Americans is likely to contribute to their shorter life expectancy
compared with white Americans. References External links
MedlinePlus Encyclopedia Hypertensive heart disease
Hypertensive Heart Disease at eMedicine

1 Reply to “Hypertensive heart disease”

  1. Good info the best info that I have had was by following the Wilfs Calmer Plan (just google it) – I found it the no.1 method that I have ever seen.

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