This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Clinical Mechanistic Overview

Ramachandran S. Vasan, MD; Daniel Levy, MD

Arch Intern Med. 1996;156(16):1789-1796.

Abstract
Hypertension plays a key role in the evolution of the syndrome of heart failure. Hypertension has been identified as the chief precursor of left ventricular hypertrophy. Hypertensive left ventricular hypertrophy can lead to ventricular diastolic dysfunction; it is also a risk factor for myocardial infarction, which is a principal cause of left ventricular systolic dysfunction. Asymptomatic left ventricular dysfunction, whether systolic or diastolic, culminates in clinically overt heart failure when a threshold is exceeded or when other precipitating factors are superimposed. The onset of overt heart failure heralds a bleak outcome. These structural and functional changes associated with hypertension evolve over decades and are preventable with effective antihypertensive treatment. These observations emphasize the importance of early diagnosis and effective treatment of hypertension to prevent cardiac complications.

Arch Intern Med. 1996;156:1789-1796

Author Affiliations
From the Framingham Heart Study, Framingham, Mass (Drs Vasan and Levy); the Divisions of Cardiology and Clinical Epidemiology, Beth Israel Hospital, (Dr Levy), and Boston University School of Medicine (Drs Vasan and Levy), Boston, Mass; and the National Heart, Lung and Blood Institute, Bethesda, Md (Dr Levy).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

{beta}-Blocker Use for the Stages of Heart Failure
Klapholz
Mayo Clin Proc. 2009;84:718-729.
ABSTRACT | FULL TEXT  

Hypertension-induced remodeling of cardiac excitation-contraction coupling in ventricular myocytes occurs prior to hypertrophy development
Chen-Izu et al.
Am. J. Physiol. Heart Circ. Physiol. 2007;293:H3301-H3310.
ABSTRACT | FULL TEXT  

Chronic sodium hydrosulfide treatment decreases medial thickening of intramyocardial coronary arterioles, interstitial fibrosis, and ROS production in spontaneously hypertensive rats
Shi et al.
Am. J. Physiol. Heart Circ. Physiol. 2007;293:H2093-H2100.
ABSTRACT | FULL TEXT  

Electrocardiographic left ventricular hypertrophy in GUSTO IV ACS: an important risk marker of mortality in women
Westerhout et al.
Eur Heart J 2007;28:2064-2069.
ABSTRACT | FULL TEXT  

Arterial stiffness: reflections on the arterial pulse
O'Rourke and Franklin
Eur Heart J 2006;27:2497-2498.
FULL TEXT  

Long-Term and Short-Term Changes in Antihypertensive Prescribing by Office-Based Physicians in the United States
Stafford et al.
Hypertension 2006;48:213-218.
ABSTRACT | FULL TEXT  

Review: From Hypertension to Heart Failure -- Are There Better Primary Prevention Strategies?
Meredith and Ostergren
Journal of Renin-Angiotensin-Aldosterone System 2006;7:64-73.
ABSTRACT  

Reduced Left Ventricular Functional Reserve in Hypertensive Patients With Preserved Function at Rest
Kozakova et al.
Hypertension 2005;45:619-624.
ABSTRACT | FULL TEXT  

Angiotensin converting enzyme insertion/deletion polymorphism and the risk of heart failure in hypertensive subjects
Schut et al.
Eur Heart J 2004;25:2143-2148.
ABSTRACT | FULL TEXT  

Effect of Aldosterone Antagonism on Myocardial Dysfunction in Hypertensive Patients With Diastolic Heart Failure
Mottram et al.
Circulation 2004;110:558-565.
ABSTRACT | FULL TEXT  

Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: The Cardiovascular Health Study
Drazner et al.
J Am Coll Cardiol 2004;43:2207-2215.
ABSTRACT | FULL TEXT  

Heart failure with preserved left ventricular systolic function: epidemiology, clinical characteristics, and prognosis
Hogg et al.
J Am Coll Cardiol 2004;43:317-327.
ABSTRACT | FULL TEXT  

Chronic all-trans retinoic acid treatment prevents medial thickening of intramyocardial and intrarenal arteries in spontaneously hypertensive rats
Lu et al.
Am. J. Physiol. Heart Circ. Physiol. 2003;285:H1370-H1377.
ABSTRACT | FULL TEXT  

Relation Between Left Ventricular Midwall Function and Coronary Vasodilator Capacity in Arterial Hypertension
Kozakova et al.
Hypertension 2003;42:528-533.
ABSTRACT | FULL TEXT  

Left ventricular mass index in aortic valve surgery: a new index for early valve replacement?
Fuster et al.
Eur. J. Cardiothorac. Surg. 2003;23:696-702.
ABSTRACT | FULL TEXT  

Analysis of a Large Cohort of Health Maintenance Organization Patients With Congestive Heart Failure
Gladowski et al.
American Journal of Medical Quality 2003;18:73-81.
ABSTRACT  

Ventricular Adrenomedullin System in the Transition From LVH to Heart Failure in Rats
Nishikimi et al.
Hypertension 2003;41:512-518.
ABSTRACT | FULL TEXT  

Coronary Vasodilator Capacity and Hypertension-Induced Increase in Left Ventricular Mass
Kozakova et al.
Hypertension 2003;41:224-229.
ABSTRACT | FULL TEXT  

Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure as Predictors of Risk for Congestive Heart Failure in the Framingham Heart Study
Haider et al.
ANN INTERN MED 2003;138:10-16.
ABSTRACT | FULL TEXT  

Hypertensive crisis and acute, reversible, left ventricular systolic dysfunction: a case report
D'Aloia et al.
Eur J Heart Fail 2002;4:655-660.
FULL TEXT  

Local Hemodynamic Changes in Hypertension: Insights for Therapeutic Preservation of Target Organs
Frohlich
Hypertension 2001;38:1388-1394.
ABSTRACT | FULL TEXT  

Implications of increased left ventricular mass index on in-hospital outcomes in patients undergoing aortic valve surgery
Mehta et al.
J. Thorac. Cardiovasc. Surg. 2001;122:919-928.
ABSTRACT | FULL TEXT  

Review: Promise of prevention and reversal of target organ involvement in hypertension
Frohlich
Journal of Renin-Angiotensin-Aldosterone System 2001;2:S4-S9.
 

Myocardial cell damage in human hypertension
Pons-Llado et al.
J Am Coll Cardiol 2000;36:2198-2203.
ABSTRACT | FULL TEXT  

Diastolic heart failure
Mandinov et al.
Cardiovasc Res 2000;45:813-825.
ABSTRACT | FULL TEXT  

The necessity for recognition and treatment of patients with "mild" hypertension
Frohlich
J Am Coll Cardiol 1999;34:1369-1377.
ABSTRACT | FULL TEXT  

Risk Mechanisms in Hypertensive Heart Disease
Frohlich
Hypertension 1999;34:782-789.
ABSTRACT | FULL TEXT  

Ventricular Pacing With Premature Excitation for Treatment of Hypertensive-Cardiac Hypertrophy With Cavity-Obliteration
Kass et al.
Circulation 1999;100:807-812.
ABSTRACT | FULL TEXT  

Alterations in calcium handling in cardiac hypertrophy and heart failure
Balke and Shorofsky
Cardiovasc Res 1998;37:290-299.
ABSTRACT | FULL TEXT  

The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Arch Intern Med 1997;157:2413-2446.
ABSTRACT