What occurs in the heart response to hypertension?
The heart responds to chronic hypertension with a series of adaptive changes that maintain cardiac output but cause structural changes in the heart.
1. Left ventricular hypertrophy:
- Hypertension increases the workload on the heart, causing the left ventricle to contract with more force to maintain systolic blood pressure.
- This increased workload leads to the hypertrophy or thickening of the left ventricular wall.
- Left ventricular hypertrophy compensates for the increased workload but eventually leads to diastolic dysfunction and heart failure if hypertension persists.
2. Myocardial fibrosis:
- Hypertension can damage the heart muscle, leading to the replacement of functional myocardial tissue with fibrotic tissue.
- Myocardial fibrosis reduces the heart's ability to contract effectively and impairs diastolic relaxation.
3. Dilated cardiomyopathy:
- In some cases of severe and long-standing hypertension, the heart muscle becomes weakened and dilated, leading to dilated cardiomyopathy.
- Dilated cardiomyopathy is a serious condition that can cause heart failure and arrhythmias.
4. Ischemic heart disease:
- Hypertension is a major risk factor for ischemic heart disease, which occurs when the blood supply to the heart is reduced.
- Hypertension accelerates the development of atherosclerosis, the buildup of plaque in the arteries, which can narrow or block the arteries supplying the heart.
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