Table 1.

Clinical Hypertensive Heart Disease Findings: Human Phenotype With Heart Failure

High blood pressure (>140/90 mm Hg; may be normal in end stages)
Breathlessness at rest or with minimal activity
Fatigue
Edema
LVH (concentric hypertrophy with cardial myocytes demonstrating an increased diameter) or increased LV mass
Impaired active relaxation
Impaired passive filling
Impaired regional midwall systolic function
Impaired EF (late)
Dilated LV internal chamber (late)
Mitral regurgitation
Enlarged left atrium
Atrial fibrillation
Conduction abnormalities
Ventricular arrhythmias
Concomitant coronary artery disease
Previous myocardial infarction
Myocardial fibrosis (reactive and replacement)
Abnormal pressure/volume relationship in the LV with increased LV filling pressure (increased chamber stiffness) relative to LV volume
Decreased intramyocardial capillary density
Coronary arteriolar thickening
Decreased coronary blood flow reserve
Increase biomarkers such as NT-proBNP, BNP, and troponin
Obesity, type 2 diabetes mellitus insulin resistance
  • LVH indicates left ventricular hypertrophy; LV, left ventricular; EF, ejection fraction; BNP, B-type natriuretic peptide; and NT-proBNP, N-terminal pro-B-type natriuretic peptide.