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Patient Instructions

Hypertensive heart disease refers to coronary artery disease, heart failure, and enlargement of the heart that occur because of high blood pressure.

See also:

• Hypertension
• Malignant hypertension

High blood pressure increases the pressure in blood vessels. As the heart pumps against this pressure, it must work harder. Over time, this causes the heart muscle to thicken and the left ventricle to become enlarged. The amount of blood pumped by the heart each minute (cardiac output) goes down. Without treatment, symptoms of congestive heart failure may develop.

High blood pressure is the most common risk factor for heart disease and stroke. It can cause ischemic heart disease from the increased supply of oxygen needed by the thicker heart muscle.

High blood pressure also contributes to thickening of the blood vessel walls. This may worsen atherosclerosis (increased cholesterol deposits in the blood vessels). This also increases the risk of heart attacks and stroke.

Hypertensive heart disease is the leading cause of illness and death from high blood pressure.

The heart complications that develop determine the symptoms, diagnosis, treatment, and outlook of hypertensive heart disease.

See also:

• Angina
• Dilated cardiomyopathy
• Heart failure
• Hypertrophic cardiomyopathy

• Angina
• Arrhythmias
• Heart attack
• Heart failure
• Stroke
• Sudden death

Call your health care provider if you have high blood pressure and develop any symptoms.

Have your blood pressure checked at regular intervals (as recommended by your health care provider) to monitor the condition. Frequent blood pressure measurements taken at home are often recommended for people with difficult-to-control high blood pressure.

Treat your high blood pressure. Do not stop or change treatment, except on the advice of your health care provider.

Carefully control diabetes, hyperlipidemia, and other conditions that increase the risk of heart disease.

In addition to medications, recommended lifestyle changes include:

• Diet changes:
  • Avoid trans fats and saturated fats
  • Increase fruits, vegetables, and low-fat dairy products
  • Reduce salt intake (may be beneficial)
  • Eat whole grains, poultry, and fish
• Exercise regularly
• Reduce excessive alcohol consumption
• Stop smoking -- cigarettes are a major cause of hypertension-related heart disease
• Lose weight if you are overweight or obese

Victor RG, Kaplan NM. Systemic hypertension: mechanisms and diagnosis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa; Saunders Elsevier; 2007: chap 40.

Updated by: Alan Berger, MD, Assistant Professor, Divisions of Cardiology and Epidemiology, University of Minnesota, Minneapolis, MN. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.