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Poorly controlled hypertension can cause hypertensive cardiomyopathy

Poorly controlled hypertension can cause hypertensive cardiomyopathy

High blood pressure is recognized as a risk factor for injury to important organs in our body, such as the kidneys, eyes, brain and heart.

On certain occasions, such as hypertension, when blood pressure is high for a long period or when there is delay in diagnosis and treatment, there is a greater risk for cardiac injury.

Cardiomyopathy is a term used to denote a group of diseases that affect the heart muscle, This is a form that there is impairment in the function of "pump" of this organ and there may be evolution for heart failure.

Myocardiopathy is a term used to denote a group of diseases that affect the heart muscle, so that there is impairment in the pump function ? hypertensive cardiomyopathy occurs when hypertension leads to damage and dysfunction of the heart muscle. Every hypertensive patient should be evaluated for hypertensive cardiopathy, since they are at risk of developing hypertension. Uncontrolled hypertension or late diagnosis, in addition to those cases of hypertension with early onset (less than 40 years of age), may be at increased risk of developing hypertensive heart disease over the years.

There is clarity in the association between pressure and cardiac risk, but it is not possible to predict with certainty which patients and how soon they will present the evolution for cardiomyopathy, so that the control of blood pressure values ​​is still the most effective measure in the prevention of cardiopathy. injury to the heart muscle can be understood by the greater difficulty or overload that the muscle has to face each beat because of a greater "obstacle", which would be a system with high pressure that in which to be overcome so that the heart beat is effective and circulation of blood by all other organs. Some genetic changes involving hormones and substances released mainly by the kidneys and blood vessels contribute to a cascade of events that ultimately leads to cardiomyopathy. The interaction of the cardiac muscle with these factors is what determines the speed of these changes in each individual.

The diagnosis of hypertensive cardiomyopathy occurs with the analysis of a set of factors:

Clinical history and physical examination. A hypertensive patient who develops tiredness for activities that were previously easy to perform, palpitations, and iedema on the extremities may eventually compromise the cardiac muscle. The physician during physical examination can detect changes in chest inspection, assess extremity edema, and observe cardiac and pulmonary auscultation abnormalities

Electrocardiogram. This rapid and easy-to-perform test may provide indirect signs of cardiac muscle disease, indicating an increase in the size of the cardiac chambers or changes in electrical conduction due to uncontrolled arterial hypertension

  • Doppler echocardiogram, a fundamental exam in this diagnosis, since it provides information about structure of the heart (if there is enlargement of the heart cavities or hypertrophy that corresponds to the increase of muscle mass) and also on the function, since in advanced stages of the disease the heart can lose its contractile force, that is, to weaken. Echo also assists in staging the disease as well, since at the beginning it may only be difficult to relax the muscle - sometimes asymptomatic, but in advanced stages hypertrophy and loss of heart function, eventually until dilation
  • image such as magnetic resonance imaging and cardiac tomography are requested, not as routine, but depending on the characteristics of each case.The treatment comprises blood pressure control with lifestyle modifications (adequate nutrition and physical activity) and antihypertensive drugs. When high blood pressure accompanies heart disease, pharmacological treatment changes, with preference given to the combination of beta-blockers and other drugs that block a system called renin-angiotensin-aldosterone. Some of these drugs may at the same time have a beneficial effect on the blood pressure level.
  • Even if the treatment is optimized, once the heart structure changes, the goal will be to prevent or slow the progression of the disease, initial conditions. Therefore, preventive blood pressure treatment is the most important.

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