Hypertensive Heart Disease: Are You at Risk?

What is Hypertensive Heart Disease?

Hypertensive heart disease is a condition that develops over many years in people who have uncontrolled high blood pressure. Persistent high blood pressure puts a strain on your heart and makes it harder for it to pump blood, which can lead to a group of heart conditions like arrhythmia (irregular heartbeat), weakened heart muscles, and heart failure, all of which are associated with hypertensive heart disease.

How Does Hypertension Cause Heart Failure and Heart Disease?

When you have hypertension, the pressure exerted by your blood as it flows through your blood vessels can damage the elasticity of their walls and cause minute tears in the inner lining of the walls. An excess of a fatty substance, called cholesterol, can accumulate in the damaged parts of your blood vessels, resulting in the formation of plaque.

Plaque build-up can cause your coronary arteries (arteries that supply blood to your heart) to become stiff, clogged and narrow, leading to reduced blood and oxygen supply to your heart.

Reduced oxygen supply can cause your heart muscles to become tired and weak, making your heart unable to effectively pump blood to the rest of your body. Thus, hypertension can lead to heart disease and heart failure if left untreated. 

What are the Types of Hypertensive Heart Disease?

In general, hypertensive heart disease can cause problems in the blood vessels and muscles of your heart, leading to:

• Coronary Artery Disease (CAD)

Coronary arteries supply blood and oxygen to your heart muscle. When high blood pressure and plaque build-up cause your blood vessels to become clogged and narrow, blood flow to your heart can be interrupted partially or completely. This condition is known as coronary artery disease. 

CAD makes it difficult for your heart to function efficiently and supply the rest of your organs with blood. It can also put you at an increased risk of having a heart attack, as small pieces of plaque can break off and form blood clots that obstruct blood flow in the coronary arteries.

• Left Ventricular Hypertrophy (LVH)

High blood pressure can reduce blood flow to your heart muscles which can weaken them. Weaker heart muscles have to work harder to pump blood throughout your body. Constant hard work and strain can cause your heart muscles to thicken and grow. This can alter the way your heart functions. 

These changes usually happen in the left ventricle (the main pumping chamber of the heart), and lead to a condition called left ventricular hypertrophy (Left ventricular enlargement). LVH can lead to complications like an irregular heartbeat or heart failure, as your heart is unable to pump blood effectively throughout your body.

What are the Risk Factors for Hypertensive Heart Disease?

The following are the risk factors for hypertensive heart disease:

• Having uncontrolled high blood pressure
• Having Type 1 or Type 2 Diabetes, or high blood sugar levels
• Having high cholesterol levels
• Lack of exercise
• Being over the age of 45 years
• Being overweight or obese
• Smoking
• Eating an unhealthy, high-sodium diet
• Excessive alcohol consumption

What are the Signs and Symptoms of Hypertensive Heart Disease?

The following are the signs and symptoms of hypertensive heart disease:

• Chest pain (angina)
• Tightness or pressure in the chest
• Shortness of breath
• Fatigue
• Pain in the neck, jaw, back, arms, or shoulders
• Persistent cough
• Loss of appetite
• Swollen ankles or legs
• Palpitations
• Dizziness/fainting 

How is Hypertensive Heart Disease Diagnosed?

Hypertensive heart disease and related cardiovascular problems can be diagnosed through the following tests:

• Electrocardiogram (ECG), a test which is used to record any abnormalities in the rhythm of your heartbeat and electrical signals generated by the contractions of your heart muscles.
• Echocardiogram, an ultrasound scan which can be used to detect structural abnormalities in your heart and surrounding blood vessels.
• Angiogram, an X-ray performed after the injection of a special dye into your blood. This test can help pinpoint any blockages in your blood vessels. 
• Cardiac stress test, is a test that measures how well your heart functions under physical stress (exercise).

What Does the Treatment of Hypertensive Heart Disease Entail?

The treatment prescribed for hypertensive heart disease may vary based on the severity of your condition, your age, and overall health. The following are the available treatment options for the various heart diseases caused by hypertension:

1.Medication

Your doctor may prescribe medication to:

• Lower your blood pressure levels
• Reduce your blood cholesterol levels
• Relieve any chest pain you may be experiencing
• Prevent the formation of blood clots

These medicines can help prevent your condition from worsening and improve blood flow to your heart.

2.Surgery

In severe cases of heart disease or heart failure, the following surgical interventions may be required:

• Angioplasty

It is a medical procedure that involves widening your blood vessels using a stent or a balloon catheter in order to improve blood flow to your heart muscles.

• Coronary Artery Bypass Graft (CABG) surgery

It is a surgical procedure used to divert blood supply away from the clogged portion of your coronary arteries and restore normal blood supply to your heart muscles.

• Heart transplant

In cases of severe coronary artery disease or end-stage heart failure, a heart transplant may be required. Your doctor may recommend a heart transplant if all other treatment options failed to improve your condition. 

3.Medical device implantation

Your doctor may recommend implanting a device like a pacemaker or an implantable cardioverter-defibrillator (ICD) if your heartbeat is too slow or irregular. These devices are implanted in your chest and they ensure that your heart is beating steadily and functioning normally.

Along with the above treatment measures, your doctor may also recommend lifestyle modifications like dietary changes, regular exercise, and quitting smoking in order to alleviate your condition.

What are the Complications of Hypertensive Heart Disease?

Coronary artery disease and left ventricular hypertrophy can lead to the following complications if left untreated:

• Arrhythmia, or irregular heartbeat caused by enlarged heart muscles. 
• Heart failure, caused by reduced blood supply and weakened heart muscles.
• Heart attack, caused by obstructed blood flow to the heart.
• Stroke, caused by obstructed blood flow to your brain.
• Sudden cardiac death, a condition that results in death due to abrupt loss of cardiac function.

Can Hypertensive Heart Disease be Prevented?

Hypertensive heart disease and associated complications like arrhythmia, heart attack, heart failure, etc. can be prevented through the following measures:

• Keep your blood pressure levels under 130/80 mmHg or a target range recommended by your doctor.
• Take all the medications prescribed to you by your doctor and follow your treatment plan strictly.
• Keep your blood sugar and cholesterol levels in check.
• Maintain a healthy weight (body mass index or BMI under 25 kg/m2). 
• Follow a low-sodium, heart-healthy DASH diet.
• Get at least 30 minutes of moderate-intensity exercise daily.
• Quit smoking.
• Get at least 7 to 9 hours of sleep every night.
• Learn to manage stress in a healthy way.
• Limit or avoid alcohol and caffeine consumption. 

When to See a Doctor?

Seek immediate medical assistance if your blood pressure reading is above 180/120 mmHg or if you experience two or more of the following symptoms of a heart attack:

• Pain in the jaw, neck, back, or left arm
• Chest pain, discomfort, and tightness
• Feeling dizzy or light-headed
• Shortness of breath
• Nausea, vomiting, or indigestion
• Fatigue or weakness