Chronic hypertension increases the risk of cardiovascular disease and also causes serious damage to the blood vessels, affecting blood supply to multiple organs including the heart. These cardiac complications, both structural and functional damage inflicted on the heart due to high blood pressure are collectively referred to as hypertensive heart disease. Middle aged individuals who are obese and have a history of poor diabetes control are at higher risk of this condition.
“The key distinction between hypertensive heart disease and other heart conditions lies in its underlying cause – prolonged elevated blood pressure”, adds Dr Bharat Jain, consultant, Cardiology, SRV Hospitals, Mumbai.
Dr Jain explains that though hypertensive heart disease is directly linked to hypertension, high blood pressure itself acts as a catalyst that aggravates other adverse cardiac conditions including high cholesterol, congenital structural defects, or genetic predisposition to increase the risk of cardiac complications in these individuals.
Dr N Sandeep Consultant, Cardiology, Manipal Hospitals, Vijayawada, says, hypertensive heart disease is caused by the structural changes that occur in the heart as a response to prolonged high blood pressure.
“Persistent high blood pressure puts a lot of strain on your heart and makes it harder to pump the blood eventually leading to the thickening of the heart muscle, especially the left ventricular chamber. This increases the risk of heart failure and sudden cardiac arrest,” he adds.
Complications of hypertensive heart disease
Hypertensive heart disease mainly impacts blood circulation across the body. Experts point out that apart from causing multiple cardiac conditions, it could also lead to stroke, if blood supply to the brain gets affected. Some of the common complications due to hypertensive heart disease include:
1. Heart attack and stroke
Dr Sandeep highlights that hypertensive heart disease can increase the risk of strokes. Blood circulating at high pressure could damage the blood vessels and lead to plaque formation. This also increases the risk of blood clot formation which could reduce or block blood flow to various organs including the brain. “Reduced blood flow and lack of adequate oxygen supply to the brain are the prime reasons for stroke,” he adds. When these blood clots form and block the supply of oxygenated blood to the heart, it could cause heart attack.
2. Heart Failure
Hypertensive heart disease could often lead to heart failure. Dr Thejaswi Marla, cardio thoracic vascular surgeon, Fortis Malar Hospital, Chennai says, heart failure can occur even without a major heart attack in people with prolonged and unmanaged hypertension. According to the American Heart Association, the workload of the heart to pump blood increases considerably due to the vascular damage. Blood flowing at high blood pressure could lead to narrowed and thickened arteries which make it difficult for the blood to flow to various organs and force the heart to pump harder. This overexertion could lead to the thickening of the cardiac muscles and make the heart enlarged in size. Restricted blood flow and muscle thickening affects the pumping of the heart and leads to heart failure.
Hypertensive heart disease increases the risk of arrhythmia (abnormal heart rhythms), most commonly atrial fibrillation ( irregular heart rhythm in upper chamber). Additionally, both supraventricular arrhythmia and ventricular arrhythmias can occur in those with hypertensive heart disease, particularly when combined with left ventricular hypertrophy (thickening of walls of left ventricle).
Dr Sandeep says, “The structural changes in the heart caused by hypertension can lead to irregular electrical pathways, resulting in arrhythmias”. Usually, people with hypertension tend to have elevated heart rate.
4. Coronary Artery Disease (CAD)
“Hypertensive heart disease significantly raises the risk of coronary artery disease”, says Dr Marla. This occurs when the coronary arteries become narrow, obstructing blood flow and become more vulnerable to clot formations after carrying blood flowing at high pressure to various parts of the body. Coronary artery disease is one of the main factors responsible for heart attacks, chest pain, and other cardiovascular complications.
5. Increased risk of atherosclerosis
Atherosclerosis refers to the buildup of fatty deposits in the arteries, narrowing them and reducing blood flow. High blood pressure is one of the main reasons for plaque build-up along the arterial walls, obstructing blood flow. Hypertensive heart disease can significantly increase the risk of atherosclerosis, says Dr Marla.
6. Peripheral Artery Disease (PAD)
Peripheral Artery Disease (PAD) causes blockage in blood flow from heart to your limbs. This is caused due to plaque formation in the arteries that carry blood to your legs due to multiple factors including high blood pressure. Peripheral Artery Disease increases risk of clot formation or thrombosis and could even cause heart attack or stroke if the clot formed blocks blood supply to heart and brain. Reduced blood flow to lower parts of the body could also lead to swelling and other conditions.
Hypertensive heart disease is a serious condition that is caused due to prolonged high blood pressure. Keeping your blood pressure under control, and maintaining a healthy lifestyle by getting adequate sleep, engaging in regular exercise, and adopting a healthy diet will help control hypertension and reduce the risk of complications.