Hypertension & the Heart: Understanding Cardiac Response & Left Ventricular Hypertrophy

The heart responds to chronic hypertension with a series of adaptive changes that maintain cardiac output but cause structural changes in the heart.

1. Left ventricular hypertrophy:

- Hypertension increases the workload on the heart, causing the left ventricle to contract with more force to maintain systolic blood pressure.

- This increased workload leads to the hypertrophy or thickening of the left ventricular wall.

- Left ventricular hypertrophy compensates for the increased workload but eventually leads to diastolic dysfunction and heart failure if hypertension persists.

2. Myocardial fibrosis:

- Hypertension can damage the heart muscle, leading to the replacement of functional myocardial tissue with fibrotic tissue.

- Myocardial fibrosis reduces the heart's ability to contract effectively and impairs diastolic relaxation.

3. Dilated cardiomyopathy:

- In some cases of severe and long-standing hypertension, the heart muscle becomes weakened and dilated, leading to dilated cardiomyopathy.

- Dilated cardiomyopathy is a serious condition that can cause heart failure and arrhythmias.

4. Ischemic heart disease:

- Hypertension is a major risk factor for ischemic heart disease, which occurs when the blood supply to the heart is reduced.

- Hypertension accelerates the development of atherosclerosis, the buildup of plaque in the arteries, which can narrow or block the arteries supplying the heart.