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Diastolic dysfunction: a link between hypertension and heart failure

Sophie Lalande1, Bruce D Johnson

  • 1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.

Drugs of Today (Barcelona, Spain : 1998)
|September 23, 2008
PubMed

Insights

Diastolic heart failure, marked by preserved ejection fraction, stems from impaired left ventricular (LV) relaxation and compliance, often linked to hypertension. Early blood pressure control is key to prevention.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Diastolic heart failure presents with heart failure symptoms and preserved ejection fraction.
  • Diagnosis is often by exclusion due to indistinguishable symptoms from systolic dysfunction.
  • Hypertension is a common precursor, leading to left ventricular (LV) concentric hypertrophy.

Purpose of the Study:

  • To elucidate the pathophysiology of diastolic heart failure.
  • To highlight the role of hypertension in its development.
  • To outline current treatment and prevention strategies.

Main Methods:

  • Review of existing literature on diastolic heart failure and hypertension.
  • Analysis of the mechanisms linking hypertension to LV diastolic dysfunction.
  • Synthesis of treatment and prevention guidelines.

Main Results:

  • Diastolic dysfunction arises from decreased LV compliance and relaxation, exacerbated by hypertension-induced LV hypertrophy and collagen accumulation.
  • Hypertension leads to LV concentric hypertrophy, reducing compliance and diastolic filling.
  • Fibrillar collagen accumulation contributes to decreased compliance and diastolic dysfunction.

Conclusions:

  • Pharmacological treatment should target blood pressure normalization, LV hypertrophy regression, heart rate control, and symptom management.
  • Preventive strategies focusing on early and aggressive blood pressure control are crucial.
  • Effective management of hypertension is paramount in reducing diastolic heart failure incidence.

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