[Medical Q&A] Will the heart quietly become "fat" if you have long-term high blood pressure?

Author: Liu Machao Xuanwu Hospital, Capital Medical University

Reviewer: Xia Jinggang, Chief Physician, Xuanwu Hospital, Capital Medical University

According to statistics, 43% of hypertensive patients have left ventricular hypertrophy. If hypertensive patients cannot control their blood pressure level well for a long time, peripheral vascular resistance will increase, and the pressure on the heart to transport blood to the peripheral blood vessels will be much greater than when the blood pressure is normal, which will increase the work of the myocardium. In the long run, just like people exercising their muscles, the heart will also "exercise" myocardial cells to hypertrophy and myocardial fiber proliferation under this "high-intensity" training, causing the myocardium to become hypertrophic, the myocardial contractility to decrease, causing myocardial blood supply to decrease, ischemia, affecting heart function, and significantly increasing the probability of heart failure, arrhythmia, stroke and sudden death.

Clinically, the diagnosis of left ventricular hypertrophy caused by hypertension mainly relies on echocardiography, electrocardiogram, and X-ray examinations. Echocardiography can detect changes in heart damage at an early stage by measuring indicators such as heart size, ventricular wall thickness, heart end-systolic diameter, and cardiac ejection fraction. Therefore, patients with hypertension must undergo regular physical examinations and echocardiography.