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'''Complications of hypertension''' are clinical outcomes that result from [[hypertension|persistent elevation]] of [[blood pressure]].<ref name="pmid19393824">{{cite journal |author=White WB |title=Defining the problem of treating the patient with hypertension and arthritis pain |journal=[[The American Journal of Medicine]] |volume=122 |issue=5 Suppl |pages=S3–9 |year=2009 |month=May |pmid=19393824 |doi=10.1016/j.amjmed.2009.03.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00206-X |issn= |accessdate=2009-06-22}}</ref> Hypertension is a risk factor for all clinical manifestations of [[atherosclerosis]] since it is a risk factor for atherosclerosis it self.<ref name="pmid19110086">{{cite journal |author=Insull W |title=The pathology of atherosclerosis: plaque development and plaque responses to medical treatment |journal=[[The American Journal of Medicine]] |volume=122 |issue=1 Suppl |pages=S3–S14 |year=2009 |month=January |pmid=19110086 |doi=10.1016/j.amjmed.2008.10.013 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(08)01017-6 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19394559">{{cite journal |author=Liapis CD, Avgerinos ED, Kadoglou NP, Kakisis JD |title=What a vascular surgeon should know and do about atherosclerotic risk factors |journal=[[Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter]] |volume=49 |issue=5 |pages=1348–54 |year=2009 |month=May |pmid=19394559 |doi=10.1016/j.jvs.2008.12.046 |url=http://linkinghub.elsevier.com/retrieve/pii/S0741-5214(08)02276-3 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19275607">{{cite journal |author=Riccioni G |title=The effect of antihypertensive drugs on carotid intima media thickness: an up-to-date review |journal=[[Current Medicinal Chemistry]] |volume=16 |issue=8 |pages=988–96 |year=2009 |pmid=19275607 |doi= |url=http://www.bentham-direct.org/pages/content.php?CMC/2009/00000016/00000008/0006C.SGM |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19138169">{{cite journal |author=Safar ME, Jankowski P |title=Central blood pressure and hypertension: role in cardiovascular risk assessment |journal=[[Clinical Science (London, England : 1979)]] |volume=116 |issue=4 |pages=273–82 |year=2009 |month=February |pmid=19138169 |doi=10.1042/CS20080072 |url=http://www.clinsci.org/cs/116/0273/cs1160273.htm |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19124420">{{cite journal |author=Werner CM, Böhm M |title=The therapeutic role of RAS blockade in chronic heart failure |journal=[[Therapeutic Advances in Cardiovascular Disease]] |volume=2 |issue=3 |pages=167–77 |year=2008 |month=June |pmid=19124420 |doi=10.1177/1753944708091777 |url=http://tak.sagepub.com/cgi/pmidlookup?view=long&pmid=19124420 |issn= |accessdate=2009-06-20}}</ref> It is an independent predisposing factor for [[heart failure]],<ref name="pmid19427498">{{cite journal |author=Gaddam KK, Verma A, Thompson M, Amin R, Ventura H |title=Hypertension and cardiac failure in its various forms |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=665–80 |year=2009 |month=May |pmid=19427498 |doi=10.1016/j.mcna.2009.02.005 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00020-0 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19427502">{{cite journal |author=Reisin E, Jack AV |title=Obesity and hypertension: mechanisms, cardio-renal consequences, and therapeutic approaches |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=733–51 |year=2009 |month=May |pmid=19427502 |doi=10.1016/j.mcna.2009.02.010 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00025-X |issn= |accessdate=2009-06-20}}</ref> [[coronary artery disease]],<ref name="pmid18815511">{{cite journal |author=Agabiti-Rosei E |title=From macro- to microcirculation: benefits in hypertension and diabetes |journal=[[Journal of Hypertension]] |volume=26 Suppl 3 |issue= |pages=S15–21 |year=2008 |month=September |pmid=18815511 |doi=10.1097/01.hjh.0000334602.71005.52 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0263-6352&volume=26&issue=&spage=S15 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19363848">{{cite journal |author=Agabiti-Rosei E |title=From macro- to microcirculation: benefits in hypertension and diabetes |journal=[[Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension]] |volume=26 |issue=3 |pages=S15–9 |year=2008 |month=September |pmid=19363848 |doi= |url= |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19427499">{{cite journal |author=Murphy BP, Stanton T, Dunn FG |title=Hypertension and myocardial ischemia |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=681–95 |year=2009 |month=May |pmid=19427499 |doi=10.1016/j.mcna.2009.02.003 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00018-2 |issn= |accessdate=2009-06-20}}</ref> [[stroke]]<ref name="pmid19393824">{{cite journal |author=White WB |title=Defining the problem of treating the patient with hypertension and arthritis pain |journal=[[The American Journal of Medicine]] |volume=122 |issue=5 Suppl |pages=S3–9 |year=2009 |month=May |pmid=19393824 |doi=10.1016/j.amjmed.2009.03.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00206-X |issn= |accessdate=2009-06-20}}</ref>, [[renal disease]],<ref name="pmid12728683">{{cite journal |author=Tylicki L, Rutkowski B |title=[Hypertensive nephropathy: pathogenesis, diagnosis and treatment] |language=Polish |journal=[[Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego]] |volume=14 |issue=80 |pages=168–73 |year=2003 |month=February |pmid=12728683 |doi= |url= |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19195963">{{cite journal |author=Truong LD, Shen SS, Park MH, Krishnan B |title=Diagnosing nonneoplastic lesions in nephrectomy specimens |journal=[[Archives of Pathology & Laboratory Medicine]] |volume=133 |issue=2 |pages=189–200 |year=2009 |month=February |pmid=19195963 |doi= |url=http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=0003-9985&volume=133&page=189 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid11842376">{{cite journal |author=Tracy RE, White S |title=A method for quantifying adrenocortical nodular hyperplasia at autopsy: some use of the method in illuminating hypertension and atherosclerosis |journal=[[Annals of Diagnostic Pathology]] |volume=6 |issue=1 |pages=20–9 |year=2002 |month=February |pmid=11842376 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S1092913402249217 |issn= |accessdate=2009-06-20}}</ref> and [[peripheral arterial disease]].<ref name="pmid18672184">{{cite journal |author=Aronow WS |title=Hypertension and the older diabetic |journal=[[Clinics in Geriatric Medicine]] |volume=24 |issue=3 |pages=489–501, vi–vii |year=2008 |month=August |pmid=18672184 |doi=10.1016/j.cger.2008.03.001 |url=http://journals.elsevierhealth.com/retrieve/pii/S0749-0690(08)00012-8 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19008688">{{cite journal |author=Gardner AW, Afaq A |title=Management of lower extremity peripheral arterial disease |journal=[[Journal of Cardiopulmonary Rehabilitation and Prevention]] |volume=28 |issue=6 |pages=349–57 |year=2008 |pmid=19008688 |doi=10.1097/HCR.0b013e31818c3b96 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1932-7501&volume=28&issue=6&spage=349 |issn= |accessdate=2009-06-20}}</ref> it is the most important [[risk factor]] for [[cardiovascular]] [[morbidity]] and [[mortality]], in [[industrialized countries]].<ref name="pmid19149532">{{cite journal |author=Novo S, Lunetta M, Evola S, Novo G |title=Role of ARBs in the blood hypertension therapy and prevention of cardiovascular events |journal=[[Current Drug Targets]] |volume=10 |issue=1 |pages=20–5 |year=2009 |month=January |pmid=19149532 |doi= |url=http://www.bentham-direct.org/pages/content.php?CDT/2009/00000010/00000001/0003J.SGM |issn= |accessdate=2009-06-20}}</ref>
'''Complications of hypertension''' are clinical outcomes that result from [[hypertension|persistent elevation]] of [[blood pressure]].<ref name="pmid19393824">{{cite journal |author=White WB |title=Defining the problem of treating the patient with hypertension and arthritis pain |journal=[[The American Journal of Medicine]] |volume=122 |issue=5 Suppl |pages=S3–9 |year=2009 |month=May |pmid=19393824 |doi=10.1016/j.amjmed.2009.03.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00206-X |issn= |accessdate=2009-06-22}}</ref> Hypertension is a risk factor for all clinical manifestations of [[atherosclerosis]] since it is a risk factor for atherosclerosis it self.<ref name="pmid19110086">{{cite journal |author=Insull W |title=The pathology of atherosclerosis: plaque development and plaque responses to medical treatment |journal=[[The American Journal of Medicine]] |volume=122 |issue=1 Suppl |pages=S3–S14 |year=2009 |month=January |pmid=19110086 |doi=10.1016/j.amjmed.2008.10.013 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(08)01017-6 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19394559">{{cite journal |author=Liapis CD, Avgerinos ED, Kadoglou NP, Kakisis JD |title=What a vascular surgeon should know and do about atherosclerotic risk factors |journal=[[Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter]] |volume=49 |issue=5 |pages=1348–54 |year=2009 |month=May |pmid=19394559 |doi=10.1016/j.jvs.2008.12.046 |url=http://linkinghub.elsevier.com/retrieve/pii/S0741-5214(08)02276-3 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19275607">{{cite journal |author=Riccioni G |title=The effect of antihypertensive drugs on carotid intima media thickness: an up-to-date review |journal=[[Current Medicinal Chemistry]] |volume=16 |issue=8 |pages=988–96 |year=2009 |pmid=19275607 |doi= |url=http://www.bentham-direct.org/pages/content.php?CMC/2009/00000016/00000008/0006C.SGM |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19138169">{{cite journal |author=Safar ME, Jankowski P |title=Central blood pressure and hypertension: role in cardiovascular risk assessment |journal=[[Clinical Science (London, England : 1979)]] |volume=116 |issue=4 |pages=273–82 |year=2009 |month=February |pmid=19138169 |doi=10.1042/CS20080072 |url=http://www.clinsci.org/cs/116/0273/cs1160273.htm |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19124420">{{cite journal |author=Werner CM, Böhm M |title=The therapeutic role of RAS blockade in chronic heart failure |journal=[[Therapeutic Advances in Cardiovascular Disease]] |volume=2 |issue=3 |pages=167–77 |year=2008 |month=June |pmid=19124420 |doi=10.1177/1753944708091777 |url=http://tak.sagepub.com/cgi/pmidlookup?view=long&pmid=19124420 |issn= |accessdate=2009-06-20}}</ref> It is an independent predisposing factor for [[heart failure]],<ref name="pmid19427498">{{cite journal |author=Gaddam KK, Verma A, Thompson M, Amin R, Ventura H |title=Hypertension and cardiac failure in its various forms |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=665–80 |year=2009 |month=May |pmid=19427498 |doi=10.1016/j.mcna.2009.02.005 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00020-0 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19427502">{{cite journal |author=Reisin E, Jack AV |title=Obesity and hypertension: mechanisms, cardio-renal consequences, and therapeutic approaches |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=733–51 |year=2009 |month=May |pmid=19427502 |doi=10.1016/j.mcna.2009.02.010 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00025-X |issn= |accessdate=2009-06-20}}</ref> [[coronary artery disease]],<ref name="pmid18815511">{{cite journal |author=Agabiti-Rosei E |title=From macro- to microcirculation: benefits in hypertension and diabetes |journal=[[Journal of Hypertension]] |volume=26 Suppl 3 |issue= |pages=S15–21 |year=2008 |month=September |pmid=18815511 |doi=10.1097/01.hjh.0000334602.71005.52 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0263-6352&volume=26&issue=&spage=S15 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19363848">{{cite journal |author=Agabiti-Rosei E |title=From macro- to microcirculation: benefits in hypertension and diabetes |journal=[[Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension]] |volume=26 |issue=3 |pages=S15–9 |year=2008 |month=September |pmid=19363848 |doi= |url= |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19427499">{{cite journal |author=Murphy BP, Stanton T, Dunn FG |title=Hypertension and myocardial ischemia |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=681–95 |year=2009 |month=May |pmid=19427499 |doi=10.1016/j.mcna.2009.02.003 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00018-2 |issn= |accessdate=2009-06-20}}</ref> [[stroke]]<ref name="pmid19393824">{{cite journal |author=White WB |title=Defining the problem of treating the patient with hypertension and arthritis pain |journal=[[The American Journal of Medicine]] |volume=122 |issue=5 Suppl |pages=S3–9 |year=2009 |month=May |pmid=19393824 |doi=10.1016/j.amjmed.2009.03.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00206-X |issn= |accessdate=2009-06-20}}</ref>, [[renal disease]],<ref name="pmid12728683">{{cite journal |author=Tylicki L, Rutkowski B |title=[Hypertensive nephropathy: pathogenesis, diagnosis and treatment] |language=Polish |journal=[[Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego]] |volume=14 |issue=80 |pages=168–73 |year=2003 |month=February |pmid=12728683 |doi= |url= |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19195963">{{cite journal |author=Truong LD, Shen SS, Park MH, Krishnan B |title=Diagnosing nonneoplastic lesions in nephrectomy specimens |journal=[[Archives of Pathology & Laboratory Medicine]] |volume=133 |issue=2 |pages=189–200 |year=2009 |month=February |pmid=19195963 |doi= |url=http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=0003-9985&volume=133&page=189 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid11842376">{{cite journal |author=Tracy RE, White S |title=A method for quantifying adrenocortical nodular hyperplasia at autopsy: some use of the method in illuminating hypertension and atherosclerosis |journal=[[Annals of Diagnostic Pathology]] |volume=6 |issue=1 |pages=20–9 |year=2002 |month=February |pmid=11842376 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S1092913402249217 |issn= |accessdate=2009-06-20}}</ref> and [[peripheral arterial disease]].<ref name="pmid18672184">{{cite journal |author=Aronow WS |title=Hypertension and the older diabetic |journal=[[Clinics in Geriatric Medicine]] |volume=24 |issue=3 |pages=489–501, vi–vii |year=2008 |month=August |pmid=18672184 |doi=10.1016/j.cger.2008.03.001 |url=http://journals.elsevierhealth.com/retrieve/pii/S0749-0690(08)00012-8 |issn= |accessdate=2009-06-20}}</ref><ref name="pmid19008688">{{cite journal |author=Gardner AW, Afaq A |title=Management of lower extremity peripheral arterial disease |journal=[[Journal of Cardiopulmonary Rehabilitation and Prevention]] |volume=28 |issue=6 |pages=349–57 |year=2008 |pmid=19008688 |doi=10.1097/HCR.0b013e31818c3b96 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1932-7501&volume=28&issue=6&spage=349 |issn= |accessdate=2009-06-20}}</ref> it is the most important [[risk factor]] for [[cardiovascular]] [[morbidity]] and [[mortality]], in [[industrialized countries]].<ref name="pmid19149532">{{cite journal |author=Novo S, Lunetta M, Evola S, Novo G |title=Role of ARBs in the blood hypertension therapy and prevention of cardiovascular events |journal=[[Current Drug Targets]] |volume=10 |issue=1 |pages=20–5 |year=2009 |month=January |pmid=19149532 |doi= |url=http://www.bentham-direct.org/pages/content.php?CDT/2009/00000010/00000001/0003J.SGM |issn= |accessdate=2009-06-20}}</ref>

== Complications affecting the Heart ==
{{main|Left ventricular hypertrophy}}
{{main|Hypertensive cardiomyopathy}}
{{main|Myocardial infarction}}
[[Hypertensive heart disease]] is the result of structural and functional adaptations<ref name="pmid19343394">{{cite journal |author=Steinmetz M, Nickenig G |title=[Cardiac sequelae of hypertension] |language=German |journal=[[Der Internist]] |volume=50 |issue=4 |pages=397–409 |year=2009 |month=April |pmid=19343394 |doi=10.1007/s00108-008-2289-3 |url=http://dx.doi.org/10.1007/s00108-008-2289-3 |issn= |accessdate=2009-06-22}}</ref> leading to [[left ventricular hypertrophy]],<ref name="pmid16802514">{{cite journal |author=Hennersdorf MG, Strauer BE |title=[Hypertension and heart] |language=German |journal=[[Medizinische Klinik (Munich, Germany : 1983)]] |volume=101 Suppl 1 |issue= |pages=27–30 |year=2006 |month=March |pmid=16802514 |doi= |url= |issn= |accessdate=2009-06-22}}</ref><ref name="pmid17260148">{{cite journal |author=Hennersdorf MG, Strauer BE |title=[The heart in hypertension] |language=German |journal=[[Der Internist]] |volume=48 |issue=3 |pages=236–45 |year=2007 |month=March |pmid=17260148 |doi=10.1007/s00108-006-1762-0 |url=http://dx.doi.org/10.1007/s00108-006-1762-0 |issn= |accessdate=2009-06-22}}</ref><ref name="pmid15351931">{{cite journal |author=Motz W |title=[Right ventricle in arterial hypertension] |language=German |journal=[[Der Internist]] |volume=45 |issue=10 |pages=1108–16 |year=2004 |month=October |pmid=15351931 |doi=10.1007/s00108-004-1273-9 |url=http://dx.doi.org/10.1007/s00108-004-1273-9 |issn= |accessdate=2009-06-22}}</ref> [[diastolic dysfunction]],<ref name="pmid17260148">{{cite journal |author=Hennersdorf MG, Strauer BE |title=[The heart in hypertension] |language=German |journal=[[Der Internist]] |volume=48 |issue=3 |pages=236–45 |year=2007 |month=March |pmid=17260148 |doi=10.1007/s00108-006-1762-0 |url=http://dx.doi.org/10.1007/s00108-006-1762-0 |issn= |accessdate=2009-06-22}}</ref><ref name="pmid19343394">{{cite journal |author=Steinmetz M, Nickenig G |title=[Cardiac sequelae of hypertension] |language=German |journal=[[Der Internist]] |volume=50 |issue=4 |pages=397–409 |year=2009 |month=April |pmid=19343394 |doi=10.1007/s00108-008-2289-3 |url=http://dx.doi.org/10.1007/s00108-008-2289-3 |issn= |accessdate=2009-06-22}}</ref> [[CHF]], abnormalities of [[blood flow]] due to [[atherosclerosis|atherosclerotic]] [[coronary artery disease]]<ref name="pmid19343394">{{cite journal |author=Steinmetz M, Nickenig G |title=[Cardiac sequelae of hypertension] |language=German |journal=[[Der Internist]] |volume=50 |issue=4 |pages=397–409 |year=2009 |month=April |pmid=19343394 |doi=10.1007/s00108-008-2289-3 |url=http://dx.doi.org/10.1007/s00108-008-2289-3 |issn= |accessdate=2009-06-22}}</ref> and [[microvascular disease]],<ref name="pmid16802514">{{cite journal |author=Hennersdorf MG, Strauer BE |title=[Hypertension and heart] |language=German |journal=[[Medizinische Klinik (Munich, Germany : 1983)]] |volume=101 Suppl 1 |issue= |pages=27–30 |year=2006 |month=March |pmid=16802514 |doi= |url= |issn= |accessdate=2009-06-22}}</ref><ref name="pmid18815511">{{cite journal |author=Agabiti-Rosei E |title=From macro- to microcirculation: benefits in hypertension and diabetes |journal=[[Journal of Hypertension]] |volume=26 Suppl 3 |issue= |pages=S15–21 |year=2008 |month=September |pmid=18815511 |doi=10.1097/01.hjh.0000334602.71005.52 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0263-6352&volume=26&issue=&spage=S15 |issn= |accessdate=2009-06-22}}</ref><ref name="pmid19363848">{{cite journal |author=Agabiti-Rosei E |title=From macro- to microcirculation: benefits in hypertension and diabetes |journal=[[Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension]] |volume=26 |issue=3 |pages=S15–9 |year=2008 |month=September |pmid=19363848 |doi= |url= |issn= |accessdate=2009-06-22}}</ref> and [[cardiac arrhythmias]].<ref name="pmid16802514">{{cite journal |author=Hennersdorf MG, Strauer BE |title=[Hypertension and heart] |language=German |journal=[[Medizinische Klinik (Munich, Germany : 1983)]] |volume=101 Suppl 1 |issue= |pages=27–30 |year=2006 |month=March |pmid=16802514 |doi= |url= |issn= |accessdate=2009-06-22}}</ref> Individuals with left ventricular hypertrophy are at increased risk for, [[stroke]],<ref name="pmid19124445">{{cite journal |author=Wachtell K, Devereux RB, Lyle PA, Okin PM, Gerdts E |title=The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy |journal=[[Therapeutic Advances in Cardiovascular Disease]] |volume=2 |issue=6 |pages=507–13 |year=2008 |month=December |pmid=19124445 |doi=10.1177/1753944708093846 |url=http://tak.sagepub.com/cgi/pmidlookup?view=long&pmid=19124445 |issn= |accessdate=2009-06-22}}</ref> [[Heart failure|CHF]],<ref name="pmid19124445">{{cite journal |author=Wachtell K, Devereux RB, Lyle PA, Okin PM, Gerdts E |title=The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy |journal=[[Therapeutic Advances in Cardiovascular Disease]] |volume=2 |issue=6 |pages=507–13 |year=2008 |month=December |pmid=19124445 |doi=10.1177/1753944708093846 |url=http://tak.sagepub.com/cgi/pmidlookup?view=long&pmid=19124445 |issn= |accessdate=2009-06-22}}</ref> and [[sudden death]]<ref name="pmid19124445">{{cite journal |author=Wachtell K, Devereux RB, Lyle PA, Okin PM, Gerdts E |title=The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy |journal=[[Therapeutic Advances in Cardiovascular Disease]] |volume=2 |issue=6 |pages=507–13 |year=2008 |month=December |pmid=19124445 |doi=10.1177/1753944708093846 |url=http://tak.sagepub.com/cgi/pmidlookup?view=long&pmid=19124445 |issn= |accessdate=2009-06-22}}</ref>. Aggressive control of hypertension can regress or reverse left ventricular hypertrophy and reduce the risk of [[cardiovascular disease]].<ref name="pmid19097374">{{cite journal |author=Petrović D, Stojimirović B |title=[Left ventricular hypertrophy in patients treated with regular hemodialyses] |language=Serbian |journal=[[Medicinski Pregled]] |volume=61 |issue=7-8 |pages=369–74 |year=2008 |pmid=19097374 |doi= |url= |issn= |accessdate=2009-06-22}}</ref>
<ref name="pmid18367014">{{cite journal |author=Cuspidi C, Sala C, Zanchetti A |title=Management of hypertension in patients with left ventricular hypertrophy |journal=[[Current Hypertension Reports]] |volume=9 |issue=6 |pages=498–505 |year=2007 |month=December |pmid=18367014 |doi= |url= |issn= |accessdate=2009-06-22}}</ref><ref name="pmid17696957">{{cite journal |author=Simko F |title=Statins: a perspective for left ventricular hypertrophy treatment |journal=[[European Journal of Clinical Investigation]] |volume=37 |issue=9 |pages=681–91 |year=2007 |month=September |pmid=17696957 |doi=10.1111/j.1365-2362.2007.01837.x |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0014-2972&date=2007&volume=37&issue=9&spage=681 |issn= |accessdate=2009-06-22}}</ref><ref name="pmid17686377">{{cite journal |author=Wachtell K, Devereux RB, Lyle AP |title=The effect of angiotensin receptor blockers for preventing atrial fibrillation |journal=[[Current Hypertension Reports]] |volume=9 |issue=4 |pages=278–83 |year=2007 |month=August |pmid=17686377 |doi= |url= |issn= |accessdate=2009-06-22}}</ref> left ventricular hypertrophy are seen in 25% of the hypertensive patients and can easily be diagnosed by using [[echocardiography]].<ref name="pmid10358398">{{cite journal |author=Herpin D |title=[Impact of arterial hypertension on the heart] |language=French |journal=[[La Revue Du Praticien]] |volume=49 |issue=5 |pages=491–4 |year=1999 |month=March |pmid=10358398 |doi= |url= |issn= |accessdate=2009-06-22}}</ref> Underlying mechanisms of hypertensive left ventricular hypertrophy are of 2 types: [[mechanical]], mainly leading to [[myocyte]] [[hypertrophy]]; [[neuro-hormonal]], mainly resulting in a [[fibroblast|fibroblastic]] [[proliferation]].<ref name="pmid10358398">{{cite journal |author=Herpin D |title=[Impact of arterial hypertension on the heart] |language=French |journal=[[La Revue Du Praticien]] |volume=49 |issue=5 |pages=491–4 |year=1999 |month=March |pmid=10358398 |doi= |url= |issn= |accessdate=2009-06-22}}</ref>

Abnormalities of diastolic function, ranging from asymptomatic [[heart disease]]<ref name="pmid19532102">{{cite journal |author=Parekh N, Maisel AS |title=Utility of B-natriuretic peptide in the evaluation of left ventricular diastolic function and diastolic heart failure |journal=[[Current Opinion in Cardiology]] |volume=24 |issue=2 |pages=155–60 |year=2009 |month=March |pmid=19532102 |doi=10.1097/HCO.0b013e328320d82a |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0268-4705&volume=24&issue=2&spage=155 |issn= |accessdate=2009-06-22}}</ref><ref name="pmid18828641">{{cite journal |author=Biria M, Howard PA, Vacek J |title=Do statins have a role in the management of diastolic dysfunction? |journal=[[American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions]] |volume=8 |issue=5 |pages=297–303 |year=2008 |pmid=18828641 |doi= |url= |issn= |accessdate=2009-06-22}}</ref><ref name="pmid17650687">{{cite journal |author=Caserta MA, Milan A, Naso D, ''et al.'' |title=[Left ventricular diastolic function and dysfunction: a single cardiac target for various systemic diseases] |language=Italian |journal=[[Giornale Italiano Di Cardiologia (2006)]] |volume=8 |issue=5 |pages=279–98 |year=2007 |month=May |pmid=17650687 |doi= |url= |issn= |accessdate=2009-06-22}}</ref> to overt [[heart failure]],<ref name="pmid19427497">{{cite journal |author=Verma A, Solomon SD |title=Diastolic dysfunction as a link between hypertension and heart failure |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=647–64 |year=2009 |month=May |pmid=19427497 |doi=10.1016/j.mcna.2009.02.013 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00029-7 |issn= |accessdate=2009-06-22}}</ref><ref name="pmid17575480">{{cite journal |author=Ellis CR, Di Salvo T |title=Myocarditis: basic and clinical aspects |journal=[[Cardiology in Review]] |volume=15 |issue=4 |pages=170–7 |year=2007 |pmid=17575480 |doi=10.1097/CRD.0b013e31806450c4 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1061-5377&volume=15&issue=4&spage=170 |issn= |accessdate=2009-06-22}}</ref> are common in hypertensive patients. Patients with diastolic heart failure have a preserved [[ejection fraction]], which is a measure of systolic function.<ref name="pmid17505622">{{cite journal |author=Okoshi K, Guimarães JF, Di Muzio BP, Fernandes AA, Okoshi MP |title=[Diabetic cardiomyopathy] |language=Portuguese |journal=[[Arquivos Brasileiros De Endocrinologia E Metabologia]] |volume=51 |issue=2 |pages=160–7 |year=2007 |month=March |pmid=17505622 |doi= |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302007000200004&lng=en&nrm=iso&tlng=en |issn= |accessdate=2009-06-22}}</ref><ref name="pmid17470335">{{cite journal |author=Fukuta H, Little WC |title=Diagnosis of diastolic heart failure |journal=[[Current Cardiology Reports]] |volume=9 |issue=3 |pages=224–8 |year=2007 |month=May |pmid=17470335 |doi= |url= |issn= |accessdate=2009-06-22}}</ref> Diastolic dysfunction is an early consequence of hypertension-related heart disease and is exacerbated by left ventricular hypertrophy<ref name="pmid17470335">{{cite journal |author=Fukuta H, Little WC |title=Diagnosis of diastolic heart failure |journal=[[Current Cardiology Reports]] |volume=9 |issue=3 |pages=224–8 |year=2007 |month=May |pmid=17470335 |doi= |url= |issn= |accessdate=2009-06-22}}</ref><ref name="pmid17260148">{{cite journal |author=Hennersdorf MG, Strauer BE |title=[The heart in hypertension] |language=German |journal=[[Der Internist]] |volume=48 |issue=3 |pages=236–45 |year=2007 |month=March |pmid=17260148 |doi=10.1007/s00108-006-1762-0 |url=http://dx.doi.org/10.1007/s00108-006-1762-0 |issn= |accessdate=2009-06-22}}</ref> and [[ischemia]].


== References ==
== References ==

Revision as of 15:34, 24 June 2009

Complications of hypertension are clinical outcomes that result from persistent elevation of blood pressure.[1] Hypertension is a risk factor for all clinical manifestations of atherosclerosis since it is a risk factor for atherosclerosis it self.[2][3][4][5][6] It is an independent predisposing factor for heart failure,[7][8] coronary artery disease,[9][10][11] stroke[1], renal disease,[12][13][14] and peripheral arterial disease.[15][16] it is the most important risk factor for cardiovascular morbidity and mortality, in industrialized countries.[17]

Complications affecting the Heart

Main article: Left ventricular hypertrophy
Main article: Hypertensive cardiomyopathy
Main article: Myocardial infarction

Hypertensive heart disease is the result of structural and functional adaptations[18] leading to left ventricular hypertrophy,[19][20][21] diastolic dysfunction,[20][18] CHF, abnormalities of blood flow due to atherosclerotic coronary artery disease[18] and microvascular disease,[19][9][10] and cardiac arrhythmias.[19] Individuals with left ventricular hypertrophy are at increased risk for, stroke,[22] CHF,[22] and sudden death[22]. Aggressive control of hypertension can regress or reverse left ventricular hypertrophy and reduce the risk of cardiovascular disease.[23] [24][25][26] left ventricular hypertrophy are seen in 25% of the hypertensive patients and can easily be diagnosed by using echocardiography.[27] Underlying mechanisms of hypertensive left ventricular hypertrophy are of 2 types: mechanical, mainly leading to myocyte hypertrophy; neuro-hormonal, mainly resulting in a fibroblastic proliferation.[27]

Abnormalities of diastolic function, ranging from asymptomatic heart disease[28][29][30] to overt heart failure,[31][32] are common in hypertensive patients. Patients with diastolic heart failure have a preserved ejection fraction, which is a measure of systolic function.[33][34] Diastolic dysfunction is an early consequence of hypertension-related heart disease and is exacerbated by left ventricular hypertrophy[34][20] and ischemia.

References

  1. ^ a b White WB (2009). "Defining the problem of treating the patient with hypertension and arthritis pain". The American Journal of Medicine. 122 (5 Suppl): S3–9. doi:10.1016/j.amjmed.2009.03.002. PMID 19393824. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help) Cite error: The named reference "pmid19393824" was defined multiple times with different content (see the help page).
  2. ^ Insull W (2009). "The pathology of atherosclerosis: plaque development and plaque responses to medical treatment". The American Journal of Medicine. 122 (1 Suppl): S3–S14. doi:10.1016/j.amjmed.2008.10.013. PMID 19110086. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)
  3. ^ Liapis CD, Avgerinos ED, Kadoglou NP, Kakisis JD (2009). "What a vascular surgeon should know and do about atherosclerotic risk factors". [[Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter]]. 49 (5): 1348–54. doi:10.1016/j.jvs.2008.12.046. PMID 19394559. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  4. ^ Riccioni G (2009). "The effect of antihypertensive drugs on carotid intima media thickness: an up-to-date review". Current Medicinal Chemistry. 16 (8): 988–96. PMID 19275607. Retrieved 2009-06-20.
  5. ^ Safar ME, Jankowski P (2009). "Central blood pressure and hypertension: role in cardiovascular risk assessment". Clinical Science (London, England : 1979). 116 (4): 273–82. doi:10.1042/CS20080072. PMID 19138169. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)
  6. ^ Werner CM, Böhm M (2008). "The therapeutic role of RAS blockade in chronic heart failure". Therapeutic Advances in Cardiovascular Disease. 2 (3): 167–77. doi:10.1177/1753944708091777. PMID 19124420. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)
  7. ^ Gaddam KK, Verma A, Thompson M, Amin R, Ventura H (2009). "Hypertension and cardiac failure in its various forms". The Medical Clinics of North America. 93 (3): 665–80. doi:10.1016/j.mcna.2009.02.005. PMID 19427498. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ Reisin E, Jack AV (2009). "Obesity and hypertension: mechanisms, cardio-renal consequences, and therapeutic approaches". The Medical Clinics of North America. 93 (3): 733–51. doi:10.1016/j.mcna.2009.02.010. PMID 19427502. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)
  9. ^ a b Agabiti-Rosei E (2008). "From macro- to microcirculation: benefits in hypertension and diabetes". Journal of Hypertension. 26 Suppl 3: S15–21. doi:10.1097/01.hjh.0000334602.71005.52. PMID 18815511. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help) Cite error: The named reference "pmid18815511" was defined multiple times with different content (see the help page).
  10. ^ a b Agabiti-Rosei E (2008). "From macro- to microcirculation: benefits in hypertension and diabetes". Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension. 26 (3): S15–9. PMID 19363848. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help) Cite error: The named reference "pmid19363848" was defined multiple times with different content (see the help page).
  11. ^ Murphy BP, Stanton T, Dunn FG (2009). "Hypertension and myocardial ischemia". The Medical Clinics of North America. 93 (3): 681–95. doi:10.1016/j.mcna.2009.02.003. PMID 19427499. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  12. ^ Tylicki L, Rutkowski B (2003). "[Hypertensive nephropathy: pathogenesis, diagnosis and treatment]". Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego (in Polish). 14 (80): 168–73. PMID 12728683. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)
  13. ^ Truong LD, Shen SS, Park MH, Krishnan B (2009). "Diagnosing nonneoplastic lesions in nephrectomy specimens". Archives of Pathology & Laboratory Medicine. 133 (2): 189–200. PMID 19195963. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  14. ^ Tracy RE, White S (2002). "A method for quantifying adrenocortical nodular hyperplasia at autopsy: some use of the method in illuminating hypertension and atherosclerosis". Annals of Diagnostic Pathology. 6 (1): 20–9. PMID 11842376. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)
  15. ^ Aronow WS (2008). "Hypertension and the older diabetic". Clinics in Geriatric Medicine. 24 (3): 489–501, vi–vii. doi:10.1016/j.cger.2008.03.001. PMID 18672184. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)
  16. ^ Gardner AW, Afaq A (2008). "Management of lower extremity peripheral arterial disease". Journal of Cardiopulmonary Rehabilitation and Prevention. 28 (6): 349–57. doi:10.1097/HCR.0b013e31818c3b96. PMID 19008688. Retrieved 2009-06-20.
  17. ^ Novo S, Lunetta M, Evola S, Novo G (2009). "Role of ARBs in the blood hypertension therapy and prevention of cardiovascular events". Current Drug Targets. 10 (1): 20–5. PMID 19149532. Retrieved 2009-06-20. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  18. ^ a b c Steinmetz M, Nickenig G (2009). "[Cardiac sequelae of hypertension]". Der Internist (in German). 50 (4): 397–409. doi:10.1007/s00108-008-2289-3. PMID 19343394. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help)
  19. ^ a b c Hennersdorf MG, Strauer BE (2006). "[Hypertension and heart]". Medizinische Klinik (Munich, Germany : 1983) (in German). 101 Suppl 1: 27–30. PMID 16802514. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)
  20. ^ a b c Hennersdorf MG, Strauer BE (2007). "[The heart in hypertension]". Der Internist (in German). 48 (3): 236–45. doi:10.1007/s00108-006-1762-0. PMID 17260148. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help)
  21. ^ Motz W (2004). "[Right ventricle in arterial hypertension]". Der Internist (in German). 45 (10): 1108–16. doi:10.1007/s00108-004-1273-9. PMID 15351931. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help)
  22. ^ a b c Wachtell K, Devereux RB, Lyle PA, Okin PM, Gerdts E (2008). "The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy". Therapeutic Advances in Cardiovascular Disease. 2 (6): 507–13. doi:10.1177/1753944708093846. PMID 19124445. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  23. ^ Petrović D, Stojimirović B (2008). "[Left ventricular hypertrophy in patients treated with regular hemodialyses]". Medicinski Pregled (in Serbian). 61 (7–8): 369–74. PMID 19097374. {{cite journal}}: |access-date= requires |url= (help)
  24. ^ Cuspidi C, Sala C, Zanchetti A (2007). "Management of hypertension in patients with left ventricular hypertrophy". Current Hypertension Reports. 9 (6): 498–505. PMID 18367014. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  25. ^ Simko F (2007). "Statins: a perspective for left ventricular hypertrophy treatment". European Journal of Clinical Investigation. 37 (9): 681–91. doi:10.1111/j.1365-2362.2007.01837.x. PMID 17696957. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help)
  26. ^ Wachtell K, Devereux RB, Lyle AP (2007). "The effect of angiotensin receptor blockers for preventing atrial fibrillation". Current Hypertension Reports. 9 (4): 278–83. PMID 17686377. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  27. ^ a b Herpin D (1999). "[Impact of arterial hypertension on the heart]". La Revue Du Praticien (in French). 49 (5): 491–4. PMID 10358398. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)
  28. ^ Parekh N, Maisel AS (2009). "Utility of B-natriuretic peptide in the evaluation of left ventricular diastolic function and diastolic heart failure". Current Opinion in Cardiology. 24 (2): 155–60. doi:10.1097/HCO.0b013e328320d82a. PMID 19532102. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help)
  29. ^ Biria M, Howard PA, Vacek J (2008). "Do statins have a role in the management of diastolic dysfunction?". American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions. 8 (5): 297–303. PMID 18828641. {{cite journal}}: |access-date= requires |url= (help)CS1 maint: multiple names: authors list (link)
  30. ^ Caserta MA, Milan A, Naso D; et al. (2007). "[Left ventricular diastolic function and dysfunction: a single cardiac target for various systemic diseases]". Giornale Italiano Di Cardiologia (2006) (in Italian). 8 (5): 279–98. PMID 17650687. {{cite journal}}: |access-date= requires |url= (help); Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  31. ^ Verma A, Solomon SD (2009). "Diastolic dysfunction as a link between hypertension and heart failure". The Medical Clinics of North America. 93 (3): 647–64. doi:10.1016/j.mcna.2009.02.013. PMID 19427497. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help)
  32. ^ Ellis CR, Di Salvo T (2007). "Myocarditis: basic and clinical aspects". Cardiology in Review. 15 (4): 170–7. doi:10.1097/CRD.0b013e31806450c4. PMID 17575480. Retrieved 2009-06-22.
  33. ^ Okoshi K, Guimarães JF, Di Muzio BP, Fernandes AA, Okoshi MP (2007). "[Diabetic cardiomyopathy]". Arquivos Brasileiros De Endocrinologia E Metabologia (in Portuguese). 51 (2): 160–7. PMID 17505622. Retrieved 2009-06-22. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  34. ^ a b Fukuta H, Little WC (2007). "Diagnosis of diastolic heart failure". Current Cardiology Reports. 9 (3): 224–8. PMID 17470335. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)
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