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Hypertension and diastolic heart failure
Alan H Gradman1, J Travis Wilson
1Division of Cardiovascular Disease, The Western Pennsylvania Hospital-Suite 3411 NT, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA. gradmanmd@aol.com
Current Cardiology Reports
|October 30, 2009
Summary
Hypertension can cause heart problems like left ventricular hypertrophy (LVH) and diastolic dysfunction. Current treatments focus on managing symptoms and blood pressure to slow heart failure progression.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Hypertension-induced pressure overload causes left ventricular hypertrophy (LVH), myocardial fibrosis, and diastolic dysfunction.
- Diastolic heart failure affects approximately 50% of heart failure patients, predominantly older females, presenting with fatigue, dyspnea, and edema.
Purpose of the Study:
- To review the current understanding of diastolic heart failure in hypertensive patients.
- To summarize the efficacy of various therapeutic strategies for diastolic heart failure.
Main Methods:
- Literature review of studies on hypertension, left ventricular hypertrophy, and heart failure.
- Analysis of treatment outcomes for diuretics, beta-blockers, calcium channel blockers, and renin-angiotensin-aldosterone system inhibitors.
Main Results:
- Diuretics effectively manage congestive symptoms. Beta-blockers and calcium channel blockers show potential but lack definitive trial data.
- Renin-angiotensin-aldosterone system blockers reduce blood pressure and LVH, but long-term studies show limited impact on symptoms, survival, or heart failure hospitalizations.
Conclusions:
- Antihypertensive therapy is crucial for preventing hypertension-related heart failure progression.
- In established diastolic heart failure, treatment focuses on symptom control with diuretics and other empiric therapies.
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