Symptoms of Hypertensive Heart Disease

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What is Hypertensive Heart Disease?

Hypertensive Heart Disease (HHD) is a complication of hypertension or high blood pressure. Seven in 1,000 people are suffering from HHD. It encompasses a group of diseases including heart failure, ischemic heart disease and left ventricular enlargement; together, they are the leading cause of death due to hypertension.

How does high blood pressure cause heart disease? Many factors can bring about chronic or persistent high blood pressure including chronic stress, age, obesity, diabetes and atherosclerosis. This condition increases the resistance or the force against which the heart has to pump blood to the circulation. The heart is a powerful muscle that constantly tries to overcome this workload, and to achieve this, it increases its muscle mass and size over time. This results in the enlargement of the left ventricle, the heart chamber which pumps the blood out of the heart.

With an increase in the muscle mass and workload, the heart needs more oxygen to work better. However, a reduction in the diameters of the coronary arteries which supply the heart with blood and oxygen will cause ischemia that can lead to heart failure or a heart attack.

Signs and Symptoms of Hypertensive Heart Disease

Hypertension is often called a silent killer because people often do not recognize its signs and symptoms until late in the disease, when complications such as HHD have developed.

The most common symptoms that reflect heart failure are:

  • Shortness of breath
  • Difficulty in sleeping flat on bed or suddenly waking up due to problems in breathing
  • Fatigue or weakness when doing ordinary or daily activities
  • Bloating and edema of the lower extremities
  • Nausea
  • Palpitations or irregular pulses
  • Coughing with frothy, pinkish secretion
  • Increased frequency of urination at night

Most of these symptoms are related to congestion or damming back of blood to the lungs and the rest of the body when the heart fails to pump blood forward to the arterial circulation. This may cause an accumulation of fluids in the lungs and later, an unusual increase in venous blood pressure. Hence, this condition may also be called congestive heart failure.

Symptoms that are related to ischemia or inadequate oxygenation of the heart are:

  • Chest pains related to physical exertion, relieved by rest
  • Chest pain with nausea, dizziness, shortness of breath and sweating
  • Irregular pulses
  • Fatigue and weakness

These symptoms reflect the weakening of the heart muscles due to lack of oxygen supply that can lead to a heart attack. If severe, a massive heart attack can lead to sudden death.

Symptoms related to heart enlargement include:

  • Chest pains
  • Irregular pulses
  • Shortness of breath
  • Fatigue, weakness and fainting spells

Enlargement of the heart increases a demand in oxygen supply and produce symptoms similar to those of ischemic heart disease.

What the patient feels subjectively are symptoms. When he reports these in a clinic or ER, the physician looks for objective signs to confirm the diagnosis such as high blood pressure, irregular pulses, enlargement of the heart and unusual heart sounds. Evidences of these are discovered during physical examination and laboratory tests. These may include tests like ECG, chest x-ray, echocardiogram, cardiac stress test and coronary angiogram.

Symptoms of hypertensive heart disease may be subtle at first. However, one must be aware that these warning signals may occur especially in the face of vascular disease, obesity, constant stress, diabetes, increasing age, strong family background of hypertension and heart disease, and other risk factors. Medical consultation must be sought for early diagnosis and treatment of the complications of high blood pressure.


WebMD, “High Blood Pressure and Hypertensive Heart Disease” accessed 2/23/11

MedHelp, “Hypertensive Heart Disease” accessed 2/23/11