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Growing Heart Failure Burden of Hypertensive Heart Disease: A Call to Action

Javier Díez1, Javed Butler2

  • 1Center for Applied Medical Research (CIMA), and School of Medicine, Universidad de Navarra, and Center for Network Biomedical Research of Cardiovascular Diseases (CIBERCV), Carlos III Institute of Health, Madrid, Spain (J.D.).

Hypertension (Dallas, Tex. : 1979)
|September 9, 2022
PubMed

Insights

Hypertensive heart disease (HHD) is a leading cause of heart failure. Early detection and treatment of myocardial interstitial fibrosis in HHD patients are crucial for preventing heart failure progression.

Area of Science:

  • Cardiology
  • Pathology
  • Hypertension Research

Background:

  • Hypertensive heart disease (HHD) is the second leading cause of heart failure.
  • HHD prevalence and heart failure risk are increasing despite improved hypertension management.
  • Preventing heart failure in HHD patients is a critical unmet medical need.

Purpose of the Study:

  • To advocate for expanded diagnostic and therapeutic strategies for HHD.
  • To incorporate histological changes, specifically myocardial interstitial fibrosis, into HHD management.
  • To explore noninvasive methods for diagnosing myocardial interstitial fibrosis in hypertensive patients.

Main Methods:

  • Conceptual framework analysis.
  • Review of current diagnostic and treatment limitations for HHD.
  • Proposal for integrating fibrosis detection into HHD patient evaluation.

Main Results:

  • Current HHD management focuses on ventricular changes and blood pressure control, neglecting key histological alterations.
  • Myocardial interstitial fibrosis is identified as a critical factor in HHD progression to heart failure.
  • The potential utility of imaging and circulating biomarkers for noninvasive fibrosis diagnosis is highlighted.

Conclusions:

  • Diagnosis and treatment of HHD should extend beyond current standards to include histological assessments.
  • Targeting myocardial interstitial fibrosis may prevent the transition from subclinical to overt heart failure in HHD.
  • Noninvasive detection of fibrosis could significantly advance HHD patient care.

Keywords:
fibrosisheart diseasesheart failurehypertension

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