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Hypertensive heart disease and cardiomyopathy in blacks. Diagnostic confusion
Insights
Many cases of unexplained heart disease, like cardiomyopathy, may actually be undiagnosed hypertension presenting as heart failure. This study suggests a link between hypertension and cryptogenic heart conditions in South African patients.
Area of Science:
- Cardiology
- Hypertension Research
- South African Health Studies
Background:
- Cardiomyopathy, or heart muscle disease, is often diagnosed as cryptogenic (idiopathic) when the cause is unknown.
- Hypertension (high blood pressure) is a significant risk factor for cardiovascular disease.
- Previous studies have explored the relationship between hypertension and various heart conditions.
Abstract:
Four Black South African patients, representative of a larger group, are described in detail. The common features were long periods of observation, multiple hospital admissions in both normotensive and hypertensive cardiac failure, hypertensive retinopathy and good renal function. All had been diagnosed as having cardiomyopathy. Two of the patients in a normotensive phase became hypertensive after responding to therapy for heart failure. One patient with malignant hypertension showed the features of idiopathic cardiomyopathy at necropsy. These cases are regarded as evidence in favour of the hypothesis that many cases of cryptogenic heart disease (cardiomyopathy, congestive cardiomyopathy, idiopathic cardiomegaly) are in fact cases of hypertension presenting with normotensive cardiac failure.