Cardiac sequelae of hypertension

Arterial hypertension leads to cardiac restructuring and damage. This"hypertensive heart disease" includes left ventricular hypertrophy. In addition, it is also considered responsible for diastolic and systolic dysfunction, vascular manifestations of microangiopathy and in a broader sense also coronary heart disease as well as cardiac dysrhythmias and sudden cardiac death. The pathophysiological mechanisms depend on a complex neurohumoral regulation and the ensuing change in cardiac structure and output. The initial compensation for increased cardiac demand is followed by permanent heart damage and successive decompensation. At this point the typical complaints involved in cardiac insufficiency or ischemia become evident. Determining the diagnosis is particularly important early on since the prognosis with regard to morbidity and mortality deteriorates if the hypertensive condition persists and the heart develops lasting damage.