Hypertensive Heart Disease : Overview, Types & Treatment 2024

Hypertensive heart disease refers to heart problems caused by high blood pressure. When the heart needs to work harder than normal to pump blood through your body, the high force and pressure can result in multiple issues like coronary artery disease, heart failure, and enlargement and thickening of the heart muscle. Managing high blood pressure is key to preventing the detrimental effects of hypertensive heart disease.

Overview of Hypertensive Heart Disease

Also called high blood pressure heart disease, hypertensive heart disease is caused by consistent high force against the artery walls due to elevated blood pressure. The high pressure makes the heart work harder to pump blood, resulting in the thickening of the heart muscle and alterations in the blood vessels.

Some of the key facts about hypertensive heart disease are:

  • Caused by chronically elevated blood pressure, usually 140/90 mm Hg or higher in adults.
  • Can lead to an enlarged heart, heart failure, arrhythmias, and heart attack.
  • Affects people of all ages, more often in older adults.
  • More common in African Americans, who tend to develop high blood pressure earlier in life.
  • Associated with obesity, smoking, high salt intake, diabetes, and kidney disease.
  • Treated by controlling blood pressure through medications, diet, exercise, and lifestyle changes.
  • The prognosis depends on the severity and how well blood pressure is managed.

Hypertensive heart disease develops over months and years. It may start with no symptoms but can progress to fatigue, shortness of breath, swollen legs, and other signs of heart failure. Catching and treating high blood pressure early is key to preventing this type of heart disease.

Types of Hypertensive Heart Disease

There are a few specific conditions that fall under the umbrella of hypertensive heart disease:

Left Ventricular Hypertrophy

Left ventricular hypertrophy (LVH) is the enlargement and thickening of the left pumping chamber of the heart, the left ventricle. The left ventricle has to work harder to pump against high pressure, causing the muscle to thicken and the chamber to get bigger. LVH increases the risk of heart failure, arrhythmias, and heart attack.

Hypertensive Heart Failure

Also called diastolic heart failure, this is heart failure caused by the heart being stiff and unable to relax and fill properly with blood. It is more common in people with high blood pressure and LVH. Symptoms include fatigue, shortness of breath, and edema. It can eventually lead to systolic heart failure.

Coronary Artery Disease

High blood pressure damages the arteries over time and can accelerate the buildup of plaque. This raises the risk of angina and heart attack. Hypertensive heart disease is one of the leading causes of coronary artery disease.


The increased thickness and stiffness of the left ventricle can disrupt the heart’s electrical system, leading to abnormal heart rhythms like atrial fibrillation. This raises the risk of blood clots and stroke.

Heart Attack

Hypertensive heart disease significantly increases the chances of having a myocardial infarction or heart attack. The causes include coronary artery disease, LVH, and arrhythmias which are complications of uncontrolled high blood pressure.

Key Risk Factors

Several factors raise your risk of developing hypertensive heart disease:

  • Hypertension– The #1 risk factor. The higher your blood pressure and the longer it stays elevated, the greater your risk.
  • Age– Risk increases as we age. More than half of American adults over 60 have high blood pressure.
  • Race– African Americans have higher rates of hypertension and develop it earlier in life. Hispanics and South Asians also have increased risk.
  • Family history– Genetics plays a role. If close blood relatives have hypertension, your risk is higher.
  • Obesity– Excess weight strains the cardiovascular system and is linked to high blood pressure.
  • Diabetes– About 80% of diabetics have hypertension, which accelerates heart damage.
  • Smoking– Chemicals in tobacco smoke damage blood vessels and raise blood pressure.
  • Sleep apnea– This common sleep disorder is associated with hypertension.
  • High sodium diet– Eating foods high in salt can cause elevated blood pressure in some people.
  • Excess alcohol– Drinking more than moderate amounts of alcohol increases the risk.
  • Stress– High levels of stress hormones can lead to chronic hypertension.

Knowing your risk factors equips you to take preventive steps to reduce your likelihood of developing hypertensive heart disease.

Diagnosing Hypertensive Heart Disease

Doctors use several tests to diagnose hypertensive heart disease:

  • Medical history– Your doctor will ask about risk factors, family history, symptoms, and medications.
  • Physical exam– Checking blood pressure in both arms, listening to the heart, feeling for abnormal beats, assessing edema, and examining arteries for plaque buildup.
  • Electrocardiogram (EKG)– An EKG measures the electrical activity of the heart to detect LVH, arrhythmias, and evidence of past heart attacks.
  • Echocardiogram– This ultrasound of the heart allows detailed visualization of the heart structure to screen for LVH and heart function abnormalities.
  • Stress testing– Exercise stress testing assesses how the heart responds to exertion, which can reveal hypertensive heart disease.
  • Blood tests– These check for markers of heart muscle strain and damage, cholesterol levels, and diabetes.
  • Cardiac catheterization– Invasive imaging tests directly check the arteries and heart chambers for blockages and damage.

Early detection and treatment are key, as undiagnosed hypertensive heart disease can lead to heart attack, stroke, and death. See your doctor regularly for blood pressure checks and heart disease screening.

Treatment for Hypertensive Heart Disease

Treatment focuses on lowering blood pressure to protect your heart health. Typical treatment may include:


There are many effective blood pressure-lowering medications, including:

  • Diuretics to reduce fluid
  • ACE inhibitors to relax blood vessels
  • ARBs that block angiotensin receptors
  • Beta-blockers slowing heart rate
  • Calcium channel blockers
  • Other vasodilators

Most people need a combination of two or more medications to adequately control hypertension. The goal is a blood pressure consistently under 130/80 mm Hg or lower if you have diabetes or kidney disease.

Lifestyle Changes

The medication works best combined with healthy lifestyle changes like:

  • Following the DASH diet high in fruits, vegetables, whole grains, lean proteins, nuts, and low-fat dairy; limit sodium, sweets, and alcohol.
  • Losing weight if overweight or obese through diet and exercise.
  • Being physically active 30+ minutes per day most days.
  • Quitting smoking and vaping.
  • Cutting back on alcohol intake.
  • Reducing stress through relaxation techniques.
  • Taking prescribed medications properly.
  • Monitoring blood pressure at home.
  • Getting regular medical care.

Surgery and Procedures

If medications and lifestyle changes don’t adequately control blood pressure, some procedures may help:

  • Implanted vagus nerve stimulator
  • Renal denervation disrupts nerve signals between the brain and kidneys
  • Barostimulation implant activating the carotid baroreflex system

For cases of serious, untreatable hypertension, surgeons may reroute arteries to control blood pressure.

The key is early detection and intervention. Follow your doctor’s treatment plan to manage hypertensive heart disease and prevent complications. Tell your doctor promptly about any new or worsening symptoms like chest pain, palpitations, fainting, and breathing troubles. Call 911 immediately with signs of heart attack or stroke.

With diligent treatment, many people with hypertensive heart disease can prevent severe heart damage and live full, active lives. Work closely with your medical team.

Frequently Asked Questions

Here are some common questions about hypertensive heart disease:

What are the early signs of hypertensive heart disease?

Often there are no obvious symptoms in the early stages. As it progresses, possible signs are shortness of breath, fatigue, chest pain, palpitations, fainting, and edema. But high blood pressure may already be causing silent heart damage, so get checked regularly.

What is a dangerous blood pressure level?

A reading consistently at or above 140/90 mm Hg (130/80 mm Hg for people with diabetes, chronic kidney disease, or already elevated cardiovascular risk) is considered hypertension. The higher those levels, the greater the strain on your heart and arteries.

Does hypertensive heart disease qualify for disability benefits?

Yes, if the condition significantly compromises your daily functioning and ability to work. To qualify for Social Security disability benefits your doctor must confirm that your hypertensive heart disease meets the listing for chronic heart failure or ischemic heart disease.

Can hypertensive heart disease be cured?

There is no cure, but the progression can be slowed and complications prevented with diligent treatment. Taking medications as prescribed, adopting heart-healthy lifestyle habits, and sticking with regular medical care can allow you to successfully manage hypertensive heart disease.

Can I still exercise with hypertensive heart disease?

Yes, exercise is recommended, even for people with hypertensive heart damage. Check with your doctor about an exercise plan appropriate for your condition. Start slow and build up intensity gradually. Avoid doing strenuous exercise when it’s extremely hot, humid, or cold outside.

Staying active aids rehabilitation and helps lower blood pressure, but overdoing it raises the risk of serious complications, so talk to your doctor about safe ways to exercise.


Hypertensive heart disease refers to heart problems stemming from chronically elevated blood pressure. Common issues include left ventricular hypertrophy, heart failure, coronary artery disease, arrhythmias, and heart attack. Essential treatments include medications to lower blood pressure along with diet and lifestyle changes to support heart health.

While hypertensive heart disease is progressive, getting blood pressure under control can reverse some damage and prevent complications. Make sure to take prescribed medications, monitor your blood pressure, maintain follow-up medical care, and aim to adopt healthier daily habits. Report any new symptoms promptly.

With a commitment to effective treatment under your doctor’s supervision, those with hypertensive heart disease can enjoy full and active lives for years to come. Don’t get discouraged by setbacks, and stick with your treatment plan. The effort is worth it to preserve your cardiovascular health and vitality.

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