How High Blood Pressure Can Cause Heart Valve Damage
In the connection between high blood pressure and aortic valve disease, research has suggested the high BP can cause cell damage. This can result in the loss of elasticity in the aorta and stiffening of the valve over time.
When elevated blood pressure was shown to increase the risk of mitral regurgitation, the researchers suggested elevated blood pressure can cause the valve to deteriorate 2.
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What Does Hypertension Mean
Before we cover the link between hypertension and heart failure, lets first dive into hypertension. Hypertension means the pressure inside your arteries is higher than it should be. When your blood is pumping through your arteries at a higher-than-normal pressure, it can actually damage your arteries.
Hypertension is diagnosed with a painless reading. A sphygmomanometer is the name of the cuff that measures your blood pressure.
Heres what your numbers mean:
- Normal blood pressure: < 120/< 80
- Elevated blood pressure: 120-129/ < 80
- High blood pressure : 130-139 / 80-89
- High blood pressure : 140+ / 90+
A hypertensive crisis which warrants immediate medical care is a reading of 180+/ 120+.
What Medications Are Used For Hypertensive Heart Disease
Any medicine can have side effects, but its important to keep taking your medicines. If youre worried about a side effect from your medication, your provider may be able to switch you to a different one. Medicines to treat high blood pressure include:
- Diuretics that make your body clear excess fluid out.
- Calcium channel blockers that make your blood vessels more open.
- Angiotensin-converting enzyme inhibitors that help loosen your blood vessels.
- Angiotensin II receptor blockers that help relax your blood vessels.
- Vasodilators that help blood vessels get wider.
- Renin inhibitors that help loosen up your blood vessels.
- Beta blockers that slow down your heart rate and make your hearts job easier.
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Evaluating The Endocrine System
Hypokalemia is found in patients with primary hyperaldosteronism and in patients with secondary hyperaldosteronism, Cushing disease, and Bartter syndrome. Hypokalemia is most useful in leading to further diagnostic studies if the patient has not received diuretics.
Plasma renin activity is generally depressed and serum aldosterone level is elevated in patients with primary hyperaldosteronism. Twenty-fourhour urinary catecholamine and metanephrine levels are elevated in patients with pheochromocytoma.
Elevated 24-hour urinary free cortisol and failure to suppress an early morning serum cortisol level after an overnight dexamethasone suppression test are observed in patients with Cushing disease. Thyrotropin levels may be elevated in patients with hypothyroidism and depressed in patients with hyperthyroidism.
The Diagnosis Of Heart Failure
How heart failure should be defined has been a long-standing challenge to the medical profession. However, if the diagnosis is ill-defined or suspect,, discussion of its aetiology must be of limited use. It is a fact that the diagnostic criteria for heart failure, whether in epidemiological, prevention or treatment studies, have rarely been well-defined. Marantz et al, in a 1988 review of clinical trials in heart failure, noted that many were carried out without explicit diagnostic criteria. This basic omission, they stated, might account for conflicting results regarding responses to treatment. Such a fundamental deficiency could also give misleading information as to the underlying aetiology.
OConner et al, in their study of 2498 patients in the year 2000, claimed that 65% of their subjects with heart failure had ischaemic heart disease. One might accept a diagnosis of ischaemic heart disease since all patients underwent coronary angiography. By contrast a diagnosis of heart failure is far from certain since this required the patients to have New York Heart Association functional class IIIV symptoms and chest discomfort. In the absence of clinical or radiological signs and with the inclusion of chest discomfort, the diagnosis is tilted away from heart failure and towards angina.
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What Is The Prognosis For Hypertension
The underlying disease that caused hypertension to develop must be cured or controlled. Long-term success depends on whether or not this is possible.
“Even those conditions can be managed successfully in many cats.”
If the cat has kidney, heart, or thyroid disease, it is important to treat those conditions aggressively. Hyperthyroidism is curable, as is thyrotoxic cardiomyopathy secondary to hyperthyroidism. Hypertrophic cardiomyopathy from other causes and chronic kidney failure are not. However, even those conditions can be managed successfully in many cats.
If the cat has blindness due to detached retinas, an immediate medical emergency exists. Blood pressure must be lowered quickly in order to restore vision. If the retina remain detached for more than a day or two, the prognosis is poor for a return of normal vision. Therefore, the key to a successful outcome is rapid diagnosis and early administration of medication to lower blood pressure.
What Can I Do To Prevent Or Manage High Blood Pressure
Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes. Talk with your health care team about
- Getting at least 150 minutes of physical activity each week
- Not smoking
- Managing stress
In addition to making positive lifestyle changes, some people with high blood pressure need to take medicine to manage their blood pressure. Learn more about medicines for high blood pressure.
Talk with your health care team right away if you think you have high blood pressure or if youve been told you have high blood pressure but do not have it under control.
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How Is Hypertensive Heart Disease Treated
In order to treat hypertensive heart disease, your doctor has to treat the high blood pressure that is causing it. They will treat it with a variety of drugs, including diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, angiotensin receptor blockers, and vasodilators.
In addition, your doctor may advise you to make changes to your lifestyle, including:
- Diet: If heart failure is present, you should lower your daily intake of sodium to 1,500 mg or 2 g or less per day, eat foods high in fiber and potassium, limit total daily calories to lose weight if necessary, and limit intake of foods that contain refined sugar, trans fats, and cholesterol.
- Monitoring your weight: This involves daily recording of weight, increasing your activity level , resting between activities more often, and planning your activities.
- Avoiding tobacco products and alcohol
- Regular medical checkups: During follow-up visits, your doctor will make sure you are staying healthy and that your heart disease is not getting worse.
How Is Blood Pressure Measured
Blood pressure is measured in two ways:
On blood pressure charts, the top number refers to the systolic pressure, while the number underneath refers to the diastolic pressure.
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Can Symptoms Vary Between Men And Women
The symptoms can vary between the sexes, but the most usual symptom of a heart attack for both women and men is pain or discomfort in the chest.
Some doctors say that women may be more likely to have some other symptoms also. For example, they might experience breathlessness, nausea, sickness, or pains in the back and jaw.
According to the American Heart Foundation, heart disease is the leading cause of death for women in the United States. Despite this, many women believe their symptoms are caused by less serious conditions, including acid reflux, flu, or simply aging.
What Questions Should I Ask My Doctor
- What is my personal risk of hypertensive heart disease?
- Is there anything else I can do to reduce my risk of hypertensive heart disease?
A note from Cleveland Clinic
High blood pressure is a very common condition, but some people dont even know they have it. If you have been told you have high blood pressure, its very important to take the medicines your provider ordered for you. Keeping your blood pressure under control is a key factor in preventing hypertensive heart disease. You have the power to make healthy changes in your life for a healthy heart.
Last reviewed by a Cleveland Clinic medical professional on 09/21/2021.
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What Is Hypertensive Heart Disease
Hypertensive heart disease is a long-term condition that develops over many years in people who have high blood pressure. Its a group of medical problems like heart failure and conduction arrhythmias that can happen when you dont control your high blood pressure .
Chronic high blood pressure causes hypertensive heart disease. As people get older and continue to have high blood pressure, their risk of heart disease increases. Heart failure occurs most often in people older than 65.
Chronic high blood pressure puts a strain on your heart and makes it harder for it to pump your blood. Your heart muscle can get thick and weak, possibly leading to heart failure. The walls of your blood vessels can also thicken because of high blood pressure, and this becomes more dangerous when cholesterol collects inside the blood vessels. Then your heart attack and stroke risks go up.
High blood pressure makes men twice as likely and women three times more likely to get heart failure. However, people who manage their high blood pressure can greatly reduce their risk of heart failure.
People who have hypertensive heart disease with heart failure have a higher risk for:
- Sudden cardiac death.
Taking Action Against Fluid Retention
If you gain more than 2 pounds in a day or 4 pounds in a week, Dr. Eldrin advises taking these steps:
- Think about the foods you ate in the days before your weight gain and look for sources of extra sodium or fluid in your diet that you may be able to eliminate.
- If your weight doesn’t return to normal in a day or two, call your doctor or nurse for advice. You may need to increase your diuretic medicine or reconsider how much fluid you are drinking.
How Is Hypertension Treated
Although there are several drugs that are very effective in treating human hypertension, none of these are approved for use in cats. Research efforts have determined that some of these drugs are quite effective in cats. Studies are still being done to determine which drugs are the safest and most reliable.
Some of the most commonly used medications for maintenance are amlodipine and the ACE inhibitor class of drugs benazepril and enalapril. Less commonly used drugs include beta blocker type drugs such as atenolol and propranolol or a diuretic called spironolactone. Additionally, if the hypertension is due to an underlying disease, it must also be addressed directly. Your veterinarian will recommend the best treatment options for your cat based on her specific needs.
Blood Pressure And Heart Failure Prevention
Two issues arise regarding HF when treating HTN. The first is strictly controlling high BP to prevent structural remodeling and the development of HF. The presence of a J-curve association between BP and CV outcomes have been long debated, but evidence has been controversial . The current consensus is that strict control is mostly beneficial for hypertensive patients with low CV risk, while the risk of CV outcome increases in patients with high risk for coronary heart disease . Recently, the findings from the Systolic Blood Pressure Intervention Trial , which assessed the role of intensive HTN treatment on a composite outcome that included HF, showed that a target SBP< 120mmHg was associated with a 38% relative risk reduction in HF . BP lowering in patients with ventricular hypertrophy can delay further remodeling and reduce the incidence of HF . The LV hypertrophy induced by HTN is not unidirectional, and a regression of LV mass has been observed after the pharmacological treatment of elevated BP . Improvements in LV hypertrophy have also been associated with reduced risks of CV events, including CV death, myocardial infarction, and stroke .
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Is There A Link Between Hbp And Heart Failure
Heart failure, a condition where your heart is unable to provide enough blood to the body, can take years to develop inside your body. The narrowing and blocking of blood vessels caused by high blood pressure increases your risk of developing heart failure.
- High blood pressure adds to your hearts workload: Narrowed arteries that are less elastic make it more difficult for the blood to travel smoothly and easily throughout your body causing your heart to work harder.
- Over time, a higher workload leads to an enlarged heart: In order to cope with increased demands, the heart thickens and becomes larger. While it is still able to pump blood, it becomes less efficient. The larger the heart becomes, the harder it works to meet your body’s demands for oxygen and nutrients.
What Are The Signs And Symptoms Of Hypertension
Symptoms of high blood pressure are uncommon. You cant determine if you have high blood pressure by how you feel. Headaches, nosebleeds, dizziness, fatigue, and other general symptoms are frequently mistakenly attributed to high blood pressure. When your blood pressure is normal, though, youre just as likely to have these symptoms.
However, if your high blood pressure has resulted in consequences like a heart attack, heart failure, or stroke, you may have symptoms like:
- Pain in the chest
- Confused or unable to communicate
- Vision is blurry.
- One side of your body or face is weak or paralyzed.
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Blood Pressure Goals And Consultations
The medical care of patients with hypertensive heart disease falls under two categoriestreatment of the elevated blood pressure and prevention and treatment of hypertensive heart disease. According to Eighth Report of the Joint National Committee , BP goals should be as follows :
In patients aged 60 years or older, initiate treatment for systolic BP of 150 mmHg or greater or diastolic BP of 90 mmHg or greater, and treat to below those levels.
In patients aged 60 or younger or those older than 18 years with either diabetes or chronic kidney diease, initiate treatment for SBP of 140 mmHg or greater or DBP of 90 mmHg or greater, and treat to below those levels.
A 2015 trial among patients at high risk for cardiovascular events but without diabetes, showed targeting an SBP below 120 mmHg resulted in lower rates of fatal and nonfatal major cardiovascular events, including heart failure and death from any cause, although this was at the expense of significantly higher rates of some adverse events in the intensive-treatment group.
Central Nervous System And Ophthalmologic System
Central nervous system examination findings are usually unremarkable unless the patient has had previous cerebrovascular accidents with residual deficit. CNS changes may also be seen in patients who present with hypertensive emergency.
Examination of the fundi may reveal evidence of hypertensive retinopathy, the severity of which depends on the duration and severity of the patient’s hypertension, or earlier signs of hypertension, such as arteriovenous nicking.
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The Link Between Hypertension And Heart Failure
High blood pressure is often dubbed the silent killer because you dont feel the effects of high blood pressure. Unless you have regular blood pressure readings, its nearly impossible to know youve got hypertension. High blood pressure can develop slowly over the years, and if its left untreated, it can lead to heart failure. This makes routine care even more important.
Dr. Henock Saint-Jacques of Harlem Cardiology knows that managing high blood pressure is essential for preserving your heart health. As an experienced cardiologist, Dr. Saint-Jacques diagnoses and treats hypertension, and if you have high blood pressure, we recommend that you come visit us to get it under control.
In this article, well explore the link between hypertension and heart failure and most importantly what you can do to manage hypertension.
What Is High Blood Pressure
High blood pressure, also called hypertension, is blood pressure that is higher than normal. Your blood pressure changes throughout the day based on your activities. Having blood pressure measures consistently above normal may result in a diagnosis of high blood pressure .
Your health care team can diagnose high blood pressure and make treatment decisions by reviewing your systolic and diastolic blood pressure levels and comparing them to levels found in certain guidelines.
The guidelines used to diagnose high blood pressure may differ from health care professional to health care professional:
- Some health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 140/90 mm Hg or higher.2 This limit is based on a guideline released in 2003, as seen in the table below.
- Other health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 130/80 mm Hg or higher.1 This limit is based on a guideline released in 2017, as seen in the table below.
|systolic: 130 mm Hg or higherdiastolic: 80 mm Hg or higher
If you are diagnosed with high blood pressure, talk with your health care team about your blood pressure levels and how these levels affect your treatment plan.
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