Heart failure is a complication of hypertension. How much do you know about the relationship between heart failure and hypertension?

Hello everyone, hypertension has always been regarded as a scourge by us, so why is it a scourge? Why do we still have to take medicine and control our lifestyle habits even if there are no other symptoms, and fight against this scourge? This is because increased blood pressure is not just as simple as increased blood pressure. As long as there are blood vessels, they will be at risk of increased blood pressure. At present, the heart, brain and kidneys are the first target organs to bear the brunt. Common diseases caused by high blood pressure include cerebral hemorrhage, cerebral thrombosis, lacunar cerebral infarction, transient cerebral ischemia; chronic renal failure; heart failure and coronary heart disease, as well as aortic dissection.

Today we are going to talk about heart failure caused by high blood pressure. As the name suggests, heart failure is caused by insufficient heart strength. It is like an electric pump that stops working without wires. Heart failure caused by high blood pressure refers to a group of syndromes in which the filling and/or ejection function of the ventricles are impaired due to increased blood pressure, and the cardiac output cannot meet the metabolic needs of the body's tissues, with clinical manifestations of congestion in the pulmonary circulation and/or systemic circulation, and insufficient blood perfusion of organs and tissues.

The simple understanding is that the heart can pump blood with its original strength, but because of high blood pressure, the heart needs several times the original strength to pump blood. The myocardium is like our biceps, the more you exercise, the stronger it becomes, so the myocardium will become thicker and thicker. Over time, the myocardium becomes deformed and lacks strength to fight against high blood pressure. This is why high blood pressure leads to heart failure.

When heart failure occurs, patients will feel weak, tired, have less exercise, feel panic and dizzy, which are all symptoms caused by the inability of blood to meet the needs of tissues. In addition, heart failure caused by hypertension will cause left ventricular hypertrophy, with pulmonary congestion as the main manifestation. Patients will have varying degrees of dyspnea, which will first occur with exertion, and once excessive exercise occurs, they will feel the pain of being unable to breathe. Then, sitting breathing will occur, which means that the patient cannot lie flat and must be in a semi-recumbent position to feel comfortable breathing. As the disease continues to develop, nocturnal paroxysmal dyspnea will occur, which means that even if you sleep in a semi-recumbent position, you will be awakened by suffocation. The last stage is also the most serious stage, which is acute pulmonary edema. At this time, dyspnea will occur, and wheezing will also occur. Not only will dyspnea progressively worsen, but it will also be accompanied by coughing, expectoration, and hemoptysis, and it often appears for the first time at night. Long-term pulmonary venous hypertension will cause collaterals to form between the pulmonary vascular and bronchial blood circulation under the bronchial mucosa. If the collaterals rupture at this time, it will cause massive hemoptysis.

Left heart failure will lead to increased pulmonary artery pressure, which will increase the right heart load. If right heart failure occurs, then whole heart failure will occur. Right heart failure is mainly caused by systemic blood congestion, and often there will be blood congestion in the digestive tract, which will cause abdominal distension, nausea, loss of appetite, and vomiting. If whole heart failure cannot be controlled by conventional medication, the only option is to wait for a heart transplant.

The root of all this is that we don't control our blood pressure well. If we always have the wrong idea that we only take medicine when our blood pressure is high and don't take medicine when it's not high, then heart failure is very likely to occur. This requires us to actively control our blood pressure, and we cannot stop taking the medicine casually, let alone add or subtract it at will. During the medication period, we should insist on measuring our blood pressure every day, observe the changes in our blood pressure after taking the medicine, and promptly feedback to our doctor so that we can adjust the most suitable medication plan for ourselves.

You should not relax your daily life management, maintain a good mood, avoid factors that cause high blood pressure, control your weight, especially patients who already have heart failure, should monitor their weight daily, because this can reflect urine volume and help doctors evaluate adjustment plans. Finally, dietary management is required, a low-sodium and high-potassium diet, but do not restrict salt excessively, especially when using sodium-excreting diuretics. In addition, if you already have heart failure, you need to do physical labor within your ability. But the most important thing is to control your blood pressure.

Now, do you still dare to underestimate high blood pressure? Controlling blood pressure and preventing complications are the top priorities!

References

【1】Internal Medicine, 9th edition, edited by Ge Junbo et al., People’s Medical Publishing House