Hypertensive Heart Disease

Question 1

What is Hypertensive heart disease?

Answer 1

A condition where heart changes are related to chronically elevated blood pressure causing LVH, coronary artery atheroma and CHF

Question 2

What is the incidence of HHD?

Answer 2

Very common, second only to IHD

Question 3

(answers to all three describe the pathogenesis of HHD)

1. What is the 1st step in the pathogenesis of HHD?
2. In moderate to severe LVH what happens to the myocardium?
3. What occurs as a result of the changes seen in the myocardium?
4. What is then seen if cardiac failure occurs?

Answer 3

1. Increased pressure on the left ventricle leads to LVH, this even occurs with sustained mild hypertension.
2. In moderate to severe LVH there is decreased capillary density in the myocardium and there is also interstitial fibrosis.
3. Increased thickness of the wall (LVH) and interstitial fibrosis lead to wall stiffness and impaired diastolic filling, as a result there can also be Atrial enlargement which may lead to Atrial fibrillation
4. Cardiac dilation occurs

Question 4

What is the relationship between BP and LVH?

Answer 4

There is a direct relationship between LVH and the level and duration of hypertension

Question 5

What risk factor doubles the risk of HHD?

Answer 5

Obesity