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September 9, 1996

The Role of Hypertension in the Pathogenesis of Heart Failure: A Clinical Mechanistic Overview

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).

Arch Intern Med. 1996;156(16):1789-1796. doi:10.1001/archinte.1996.00440150033003

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

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