Overview of Hypertensive Heart Disease Caused by High Blood Pressure: Factors, Symptoms, Diagnosis

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What is Hypertensive Heart Disease?

Hypertensive heart disease is heart disease caused by chronic high blood pressure, or hypertension. High blood pressure increases the workload put on your heart. Over time, your heart muscle thickens and your left ventricle becomes enlarged, a condition called left ventricular hypertrophy (LVH). LVH puts you at high risk to suffer heart attack, stroke, or death.

Hypertensive heart disease can come in the form of congestive heart failure (your heart does not get enough oxygen and cannot pump as much blood to your body), worsened atherosclerosis (cholesterol and fatty deposits in your blood vessels) as high blood pressure thickens artery walls, or ischemic heart disease (decreased blood to the heart, causing chest pain and heart attack). Hypertensive heart disease can cause chest pain, irregular heart rate, heart attack, stroke and even sudden death.

Hypertensive Heart Disease Risk Factors

If you are at risk for high blood pressure, you are at risk for hypertensive heart disease. As you age, there is increased risk for high blood pressure. Family history also plays a role, as does race (hypertension is more common in African-Americans).

While age, race and family history are not under your control in preventing hypertensive heart disease, many more risk factors are–chief among them smoking, weight and sedentary lifestyle. Excessive drinking also increases your risk, as do stress and too much salt or too little potassium in your diet. Chronic medical conditions, such as sleep apnea, high cholesterol and diabetes also increase your risk for high blood pressure and, therefore, for hypertensive heart disease.

Hypertensive Heart Disease Symptoms

If you have hypertensive heart disease you will, of course, have hypertension. Keep in mind that hypertension itself often causes no symptoms and is known as the “silent killer.” Once hypertension has damaged your heart and hypertensive heart disease has developed, the condition is life-threatening. Symptoms may include confusion, fatigue, shortness of breath, persistent coughing, swelling of the feet and ankles, headaches, vision problems, or nausea. You may also have an irregular pulse, chest pain, or kidney failure.

Diagnosis of Hypertensive Heart Disease

Hypertensive heart disease may be diagnosed when your doctor finds the signs of chronic elevated blood pressure, enlarged heart and abnormal heart sounds. You may also have signs of congestive heart failure, such as increased heart rate. Chest x-rays, EKGs (electrocardiograms), and echocardiograms may be used to diagnose hypertensive heart disease, as well as the more invasive coronary angiogram (x-ray imaging of the heart’s blood vessels), performed during heart catheterization.

Treatment of Hypertensive Heart Disease

Treatment of your hypertensive heart disease will depend what conditions it causes in you. Blood pressure control is paramount. You will be treated with antihypertensive medications (ACE inhibitors, beta blockers, calcium channel blockers). You may be treated with cholesterol-lowering medications or diuretics to reduce the amount of fluid in your body. Your doctor will recommend lifestyle changes, such as a healthy diet and regular aerobic exercise. You will likely be asked to lose weight, quit smoking and reduce alcohol and salt intake.

Prognosis for Hypertensive Heart Disease

The greater the enlargement of the left ventricle, the greater the chance for complications. You can reduce the amount of damage to the left ventricle by controlling your hypertension. Some antihypertensives and diuretics can reverse LVH and prolong survival, but hypertensive heart disease remains a serious condition that can lead to sudden death.


National Library of Medicine: Medline Plus: Hypertensive Heart Disease


Mayo Clinic: High Blood Pressure Risk Factors


American Heart Association: Signs and Symptoms of Heart Failure


MedHelp: Hypertensive Heart Disease


Medscape: eMedicine: Hypertensive Heart Disease