High blood pressure and heart disease

Hypertensive heart disease is the number one cause of death associated with high blood pressure. It is actually a group of disorders that include heart failure, ischaemic heart disease and left ventricular hypertrophy (excessive thickening of the heart muscle).

What is heart failure?

Heart failure does not mean the heart has stopped working. Rather it means that the heart's pumping power is weaker than normal or the heart has become less elastic. With heart failure blood moves through the heart and body less effectively and pressure in the heart increases. As a result the heart cannot pump enough oxygen and nutrients to meet the body's needs.

The chambers of the heart respond by stretching to hold more blood to pump through the body. This helps to keep the blood moving, but in time the heart muscle walls weaken and are unable to pump as strongly. As a result the kidneys often respond by causing the body to retain fluid (water) and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.

High blood pressure brings on heart failure by causing left ventricular hypertophy, making it difficult to fill the heart. Symptoms of heart failure include:

• Shortness of breath
• Swelling in the feet, ankles or abdomen
• Difficulty sleeping flat in bed
• Bloating
• Irregular pulse
• Nausea
• Fatigue
• Greater need to urinate at night

What is ischaemic heart disease?

High blood pressure can also cause ischaemic heart disease. This means that the heart muscle isn't getting enough blood.

Ischemic heart disease is usually the result of atherosclerosis or narrowing of the arteries ( coronary artery disease), which impedes the blood flow. This can lead to a heart attack. Symptoms of ischaemic heart disease may include:

• Chest pain that may radiate ( travel) to the arms, back, neck or jaw
• Chest pain with nausea, sweating, shortness of breath and dizziness - these associated symptoms may also occur without chest pain
• Irregular pulse
• Fatigue and weakness
• If you have any of these symptoms of ischaemic heart disease you should seek medical advice immediately.

What is hypertrophic cardiomyopathy?

Hypertrophic cardiomyopathy is a condition in which the muscular walls of the heart are abnormally thickened. This can prevent the heart valves from functioning normally or may keep blood from flowing into or out of the heart. It usually occurs independently of high blood pressure.

Symptoms of hypertrophic cardiomyopathy may include:

• Chest pain
• Irregular pulse
• Rapid heartbeat
• Shortness of breath
• Fatigue, weakness
• Fainting

How is hypertensive heart disease diagnosed?

Your doctor will look for certain signs of hypertensive heart disease including:

• High blood pressure
• Enlarged heart and irregular heartbeat
• Fluid in the lungs or lower extremities
• Unusual heart sounds

Your doctor may perform tests to determine if you have hypertensive heart disease, including an electrocardiogram, echocardiogram, cardiac stress test, chest X-ray and coronary angiogram.