Hypertensive Heart Disease

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 your high blood pressure (hypertension) is unmanaged.

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, having your high blood pressure well managed can greatly reduce your 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?

1 out of every 3 adults in America has high blood pressure, but only half of those with the diagnosis have well-managed blood pressure. 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.

What causes hypertensive heart disease?

High blood pressure that isn’t managed 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.

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.

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.

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.

What can I expect if I have hypertensive heart disease?

Hypertensive heart disease is a long-term disease that takes years to develop. Over time, people who have it are at a higher and higher risk of dying from a cardiovascular problem. The prognosis for people with hypertensive cardiovascular disease is different from person to person, depending on:

• What symptoms you’re having.
• Whether you have cardiovascular disease or risk factors.
• Other medical conditions you have.

How do I take care of myself with hypertensive heart disease?

When you have high blood pressure, it’s important to keep taking your medicines to regulate your blood pressure. You also need to watch for problems that start to develop and treat them promptly.

Conditions to watch for include:

• Ventricular hypertrophy.
• Atrial fibrillation.
• Angina.
• Heart failure.

What questions should I ask my doctor?

• What is my personal risk of hypertensive heart disease?
• Is there anything else I can do to reduce my risk of hypertensive heart disease?

A note from Cleveland Clinic

High blood pressure is a very common condition, but some people don’t even know they have it. If you have been told you have high blood pressure, it’s very important to take the medicines your provider ordered for you. Keeping your blood pressure well managed is a key factor in preventing hypertensive heart disease. You have the power to make healthy changes in your life for a healthy heart.