14. Progression From Hypertension to Heart Failure LVH, left ventricular hypertrophy; MI, myocardial infarction; CHF, chronic heart failure. Vasan RS and Levy D. Arch Intern Med. 1996;156:1789-1796. Hypertension Smoking Dyslipidemia Diabetes Obesity Diabetes MI LVH CHF Normal LV Structure and Function LV Remodeling Subclinical LV Dysfunction Overt Heart Failure Diastolic Dysfunction Systolic Dysfunction
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Hypertension can lead to LVH, diastolic or systolic dysfunction and heart failure. Progression from hypertension to LVH is due to the macro and micro changes in the ventricle (LV remodeling). This remodeling can lead to diastolic dysfunction without clinical signs or symptoms of heart failure. This emphasizes the importance of treatment in some patients prior to development of overt heart failure. Hypertension, in conjunction with other risk factors for atherosclerosis may lead to myocardial infarction. LV remodeling again takes place, but does so differently, leading to systolic dysfunction. Again, remodeling is taking place within the ventricle in response to the injury but may not lead to overt heart failure. Progression will lead to heart failure, with decreasing ejection fractions.
Hypertension can lead to LVH, diastolic or systolic dysfunction and heart failure. Progression from hypertension to LVH is due to the macro and micro changes in the ventricle (LV remodeling). This remodeling can lead to diastolic dysfunction without clinical signs or symptoms of heart failure. This emphasizes the importance of treatment in some patients prior to development of overt heart failure. Hypertension, in conjunction with other risk factors for atherosclerosis may lead to myocardial infarction. LV remodeling again takes place, but does so differently, leading to systolic dysfunction. Again, remodeling is taking place within the ventricle in response to the injury but may not lead to overt heart failure. Progression will lead to heart failure, with decreasing ejection fractions.