[Hypertension and cardiac failure]

Arterial hypertension is the leading cause of mortality and morbidity with a worldwide prevalence of 26%. Aging increases the incidence of arterial hypertension. Arterial hypertension is the prime example for a chronic disease with asymptomatic beginning, creeping course and fatal outcome. Arterial hypertension is a major cardiovascular risk factor and leads to vascular as well as myocardial manifestations: coronary artery disease, hypertensive microvascular disease, concentric left ventricular hypertrophy as well as perivascular and interstitial fibrosis. In the late stages of the disease, hypertrophy and cardiac failure develop. Arterial hypertension is the leading cause of coronary artery disease and cardiac failure, and coronary artery disease is the cause of heart failure in 50% of cases. Various non-invasive and invasive procedures are available for screening and follow-up. The primary therapeutic target is to reverse cardiac manifestations of arterial hypertension using specific therapeutic algorithms as well as lowering blood pressure. This article covers the pathophysiology of arterial hypertension and cardiac failure, clinical symptoms, diagnostic options and therapeutical goals as well as medicinal options.