Related Experiment Video

Updated: Oct 18, 2026

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
08:21

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis

Published on: October 26, 2020

State of the Art lecture. Risk mechanisms in hypertensive heart disease

E D Frohlich1

  • 1Alton Ochsner Medical Foundation, New Orleans, LA 70121, USA.

Hypertension (Dallas, Tex. : 1979)
|October 16, 1999
PubMed

Insights

Hypertensive heart disease and left ventricular hypertrophy involve coronary hemodynamic changes, endothelial dysfunction, and fibrosis. These alterations increase the risk of serious cardiac events like heart attack and failure.

Area of Science:

  • Cardiology
  • Pathophysiology

Background:

  • Hypertensive heart disease and left ventricular hypertrophy (LVH) present independent cardiovascular risks.
  • Key pathophysiological alterations include altered coronary hemodynamics and endothelial dysfunction.

Discussion:

  • Classically described coronary hemodynamic changes include reduced coronary blood flow and flow reserve, alongside increased coronary vascular resistance.
  • Emerging concepts highlight the role of endothelial dysfunction.
  • Increased collagen deposition (fibrosis) in ventricular walls and perivascularly contributes significantly to cardiac dysfunction.

Key Insights:

  • Aging and high salt intake can exacerbate these cardiac changes.
  • Functional and structural alterations lead to worsening endothelial dysfunction, impaired coronary hemodynamics, and compromised systolic and diastolic ventricular function.

Outlook:

  • Clinical consequences encompass angina, myocardial infarction, cardiac failure, lethal arrhythmias, and sudden cardiac death.
  • LVH is not solely myocytic hypertrophy; it involves comorbid changes like fibrosis, impaired hemodynamics, and endothelial dysfunction that elevate cardiac risk.

Related Concept Videos

Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...