[Arterial hypertension and systolic left ventricular dysfunction: therapeutic approach]

Area of Science:

• Cardiology
• Internal Medicine
• Hypertension Research

Background:

• Arterial hypertension is a primary cause of congestive heart failure.
• Diastolic dysfunction is the most common mechanism, while systolic dysfunction carries a worse prognosis.
• Non-ischemic hypertensive systolic dysfunction can be an etiology of chronic heart failure in up to 10% of dilated cardiomyopathy cases.

Purpose of the Study:

• To highlight the link between arterial hypertension and heart failure.
• To discuss the mechanisms of hypertensive heart failure, including diastolic and systolic dysfunction.
• To emphasize the importance of preventing left ventricular dysfunction in hypertensive patients.

Main Methods:

• Review of existing literature on hypertension and heart failure.
• Analysis of mechanisms leading to diastolic and systolic dysfunction in hypertensive patients.
• Discussion of current and potential therapeutic strategies.

Main Results:

• Hypertension is a key precursor to congestive heart failure.
• Left ventricular hypertrophy and diastolic dysfunction increase heart failure risk.
• Systolic dysfunction, though less frequent, has a poorer prognosis, often linked to myocardial infarction or non-ischemic causes.

Conclusions:

• Preventing left ventricular dysfunction through blood pressure control, regression of hypertrophy, and coronary artery disease prevention is fundamental.
• Angiotensin converting enzyme inhibitors are the primary treatment for established systolic dysfunction.
• Diuretics, digoxin, carvedilol, and losartan may be used, but evidence for the latter two is limited.