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Diastolic function in hypertension
1Department of Medicine, Lenox Hill Hospital, 100 East 77th Street, New York, NY 10021, USA. rphillips@lenoxhill.net
Insights
Hypertension can cause diastolic dysfunction, leading to heart failure even with normal systolic function. This review covers causes, measurement tools, and treatments for diastolic heart failure in hypertensive patients.
Area of Science:
- Cardiology
- Internal Medicine
- Hypertension Research
Background:
- Diastolic dysfunction is a significant cause of heart failure, particularly in hypertensive individuals.
- A substantial proportion of patients with heart failure symptoms exhibit preserved systolic function but impaired diastolic function.
- Hypertension is a primary risk factor contributing to the development of diastolic dysfunction.
Purpose of the Study:
- To review the pathophysiologic mechanisms underlying diastolic dysfunction in hypertension.
- To discuss current and novel diagnostic tools for assessing diastolic function.
- To explore contemporary treatment strategies for patients with diastolic heart failure.
Main Methods:
- Literature review of pathophysiologic factors in diastolic dysfunction.
- Analysis of current and emerging diagnostic modalities for diastolic function assessment.
- Synthesis of current treatment concepts for diastolic heart failure.
Main Results:
- Diastolic dysfunction can manifest asymptomatically or as severe pulmonary edema in hypertensive patients.
- Normal left ventricular systolic function is observed in up to 40% of hypertensive patients with congestive heart failure.
- Understanding pathophysiologic factors is crucial for effective management.
Conclusions:
- Diastolic dysfunction is a key contributor to heart failure in hypertension, often with preserved ejection fraction.
- Accurate assessment of diastolic function is vital for diagnosis and management.
- Targeted therapeutic approaches are essential for improving outcomes in patients with diastolic heart failure.
Abstract:
Diastolic dysfunction in patients with hypertension may present as asymptomatic findings on noninvasive testing, or as fulminant pulmonary edema, despite normal left ventricular systolic function. Up to 40% of hypertensive patients presenting with clinical signs of congestive heart failure have normal systolic left ventricular function. In this article we review the pathophysiologic factors affecting diastolic function in individuals with diastolic function, current and emerging tools for measuring diastolic function, and current concepts regarding the treatment of patients with diastolic congestive heart failure.