Abstract
Heart failure continues to be a significant problem faced by today’s health care professional. Heart failure remains one of the principal causes of cardiovascular morbidity and mortality. The prevalence of heart failure continues to increase, largely due to an aging population and to modern technologic innovations that have led to prolonged survival of the cardiac patient. Hypertension increases the risk for heart failure in all age groups. In those individuals aged 40 years or older whose blood pressure is > 140/90 mm Hg, the lifetime risk for developing heart failure may be twice as high as that of their aged-matched counterparts. Therefore, it is imperative that the clinician be aware of the current diagnostic and therapeutic advancements for the early detection and aggressive treatment of hypertension and heart failure, to prevent patients from developing symptoms of heart failure and to decrease the need for hospitalizations once the diagnosis is confirmed.
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References and Recommended Reading
American Heart Association: Heart Disease and Stroke Statistics 2004 Update. Dallas, TX: American Heart Association; 2003.
Mehra MR, Uber PA, Potluri S, Ventura O: Is heart failure with preserved systolic function an overlooked enigma? Curr Cardiol Rep 2002, 4:187–193.
Senni M, Redfield MM: Heart failure with preserved systolic function. A different natural history? J Am Coll Cardiol 2001, 38:1277–1282.
Vasan RS, Larson MG, Benjamin EJ, et al.: Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort. J Am Coll Cardiol 1999, 33:1948–1955.
Vasan RS, Benjamin EJ, Levy D: Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective. J Am Coll Cardiol 1995, 26:1565–1574.
Redfield MN, Jacobsen SJ, Burnett JC, et al.: Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of heart failure epidemic. JAMA 2003, 289:194–202. Excellent epidemiologic paper on the burden of heart failure on the community.
Senni M, Tribouilloy CM, Rodeheffer RJ, et al.: Congestive heart failure in the community: trends in incidence and survival in a 10-year period. Arch Intern Med 1999, 159:29–34.
Vasan RS, Benjamin EJ, Levy D: Congestive heart failure with normal left ventricular systolic function: clinical approaches to the diagnosis and treatment of diastolic heart failure. Arch Inter Med 1996, 156:146–157.
Slama M, Susic D, Varagic J, et al.: Diastolic dysfunction in hypertension. Curr Opin Cardiol 2002, 17:368–373.
Lloyd-Jones DM, Larson MG, Leip EP, et al.: Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation 2002; 106:3068–3072.
He J, Ogden LG, Bazzano LA, et al.: Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med 2001, 161:996–1002.
Kannel WB, Ho K, Thom T: Changing epidemiological features of cardiac failure. Br Heart J 1994; 72:S3-S9.
Mandinov L, Eberli FR, Seiler C, et al.: Diastolic heart failure. Cardiovasc Res 2000, 45:813–825.
Frohlich ED: Risk mechanisms in hypertensive heart disease. Hypertension 1999, 34:782–789.
Fouad-Tarazi FM: Left ventricular diastolic dysfunction in hypertension. Curr Opin Cardiol 1994, 9:551–560.
Ventura HO, Loyalka P, Smart FW: Treatment of the hypertensive patient with microvascular angina. Curr Opin Cardiol 1999, 14:370–374.
Cohn JN, Johnson G: Heart failure with normal ejection fraction. The V-HeFT Study. Veterans Administration Cooperative Study Group. Circulation 1990, 81:48–53.
Dunlap SH, Sueta CA, Adams KF: Association of body mass, gender, race with heart failure primarily due to hypertension. J Am Coll Cardiol 1999, 34:1602–1608.
Laurent D: Dynamic state of collagen: pathways of collagen degradation in vivo and their possible role in regulation of collagen mass. Am J Physiol 1987, 252:C1-C9.
Moncrieff J, Lindsay M, Dunn F: Hypertensive heart disease and fibrosis. Curr Opin Cardiol 2004, 19:326–331.
Redfield MM, Jacobsen SJ, Burnett JC, et al.: Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA 2003, 289:194–202.
Levy D, Labib SB, Anderson KM, et al.: Determinants of sensitivity and specificity of electrocardiographic criteria for left ventricular hypertrophy. Circulation 1990, 81:815–820.
Otto C: Textbook of Clinical Echocardiography, edn 3. Philadelphia: Elsevier/Saunders; 2004.
Krishnaswamy P, Lubien E, Clopton P, et al.: Utility of Bnatriuretic peptide levels in identifying patients with left ventricular systolic or diastolic dysfunction. Am J Med 2001, 111:274–279.
Lubien E, DeMaria A, Krishnaswamy P, et al.: Utility of B-natriuretic peptide levels in detecting diastolic dysfunction: comparison with Doppler velocity recordings. Circulation 2002, 105:595–601.
The SOLVD Investigators: Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991, 325:303–310.
Pfeffer MA, Braunwald E, Moye LA, et al.: Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE investigators. N Engl J Med 1992, 327:669–677.
Packer M, Bristow MR, Cohn JN, et al.: The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. The US Carvedilol Heart Failure Study Group. N Engl J Med 1996, 334:1349–1355.
The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet 1999, 353:9–13.
Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 1999, 353:2001–2007.
McMurray JJ, Ostergren J, Swedberg K, et al.: Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARMAdded trial. Lancet 2003, 362:767–771.
Pitt B, Zannad F, Remme WJ, et al.: The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999, 341:709–717.
Pitt B, Remme W, Zannad F, Neaton J: Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003; 348:1309–1321.
Taylor AL, Ziesche S, Yancy C, et al.: Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. The African-American Heart Failure trial Investigators. N Engl J Med 2004, 351:2049–2057.
Schmieder RE, Martus P, Klingbeil A: Reversal of left ventricular hypertrophy in essential hypertension. A meta-analysis of randomized double-blind studies. JAMA 1996, 275:1507–1513.
Ventura HO, Loyalka P, Smart FW: Treatment of the hypertensive patient with microvascular angina. Curr Opin Cardiol 1999, 14:370–374.
Poulsen SH, Jensen SE, Egstrup K: Effects of long-term adrenergic beta-blockade on left ventricular diastolic filling in patients with acute myocardial infarction. Am Heart J 1999, 138:710–720.
Matsubara LS, Matsubara BB, Okoshi MP, et al.: Alterations in myocardial collagen content affect rat papillary muscle function. Am J Physiol Heart Circ Physiol 2000, 279:H1534-H1539.
Warner JG Jr, Metzger DC, Kitzman DW, et al.: Losartan improves exercise tolerance in patients with diastolic dysfunction and a hypertensive response to exercise. J Am Coll Cardiol 1999, 33:1567–1572.
Diez J, Querejeta R, Lopez B, et al.: Losartan-dependent regression of myocardial fibrosis is associated with reduction of left ventricular chamber stiffness in hypertensive patients. Circulation 2002, 105:2512–2517.
Dahlof B, Devereux RB, Kjeldsen SE, et al.: Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint Reduction in Hypertension Study (LIFE): a randomised trial against atenolol. Lancet 2002, 359:995–1003.
Yusuf S, Pfeffer MA, Swedberg K, et al.: Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved trial. Lancet 2003, 362:777–781. The most impressive data to date with regard to treatment of heart failure with preserved systolic function.
Setaro JF, Zaret BL, Schulman DS, et al.: Usefulness of verapamil for congestive heart failure associated with abnormal left ventricular diastolic filling and normal left ventricular systolic performance. Am J Cardiol 1990, 66:981–986.
Terpstra WF, May JF, Smit AJ, et al.: Long term effects of amlodipine and lisinopril on left ventricular mass and diastolic dysfunction in the elderly, in previously treated hypertensive patients: the ELVERA trial. J Hypertens 2001, 19:303–309.
Hopf R, Kaltenbach M: Ten-year results and survival of patients with hypertrophic cardiomyopathy treated with calcium antagonists. Z Kardiol 1987, 76:137–144.
Bonow RO, Dilsizian V, Rosing DR, et al.: Verapamilinduced improvement in left ventricular diastolic filling and increased exercise tolerance in patients with hypertrophic cardiomyopathy: short- and long-term effects. Circulation 1985, 72:853–864.
Hunt SA, Abraham WT, Chin M, et al.: ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult. J Am Coll Cardiol 2005, 46:1–82.
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Courville, K.A., Ventura, H.O. Hypertension and heart failure: Diagnosis and management. Current Science Inc 8, 185–190 (2006). https://doi.org/10.1007/s11906-006-0049-0
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DOI: https://doi.org/10.1007/s11906-006-0049-0