| Title | Hypertension and diastolic heart failure. | | Author(s) | Gradman AH, Wilson JT | | Institution | Division of Cardiovascular Disease, The Western Pennsylvania Hospital-Suite 3411 NT, 4800 Friendship Avenue, Pittsburgh, PA, 15224, USA. gradmanmd@aol.com. | | Source | Curr Cardiol Rep 2009 Nov; 11(6):422-9. | | Abstract | In patients with hypertension, pressure overload leads to left ventricular hypertrophy (LVH), myocardial fibrosis, and impaired diastolic filling without systolic dysfunction. Presently, diastolic heart failure accounts for about 50% of the heart failure population. Fatigue, dyspnea, reduced exercise tolerance, and peripheral edema are common presenting complaints. As a group, patients with diastolic heart failure are older and predominantly female. Diuretics are effective for treating congestive symptoms. beta Blockers and heart rate-lowering calcium blockers show benefit in smaller studies but have not been evaluated in definitive clinical trials. Renin-angiotensin-aldosterone system blockers reduce blood pressure, LVH, and myocardial fibrosis; however, long-term studies with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers demonstrate little effect on symptoms or survival, and inconsistent effects on heart failure hospitalization. At present, evidence-based treatment includes antihypertensive therapy to reduce progression from hypertension to heart failure. In patients with established heart failure, diuretics and other empiric treatments are used to control symptoms. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19863866 |
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