Hypertensive heart disease
Treatment:
The goals of treatment are reduction of blood
pressure and control of the heart
disease. Treatment of heart disease depends on the manifestation
(acute MI, angina,
heart failure, and so
on).
Common medications include diuretics, potassium replacements,
beta blockers, calcium channel blockers, angiotensin-converting
enzyme (ACE) inhibitors,
angiotensin II receptor antagonists and direct vasodilators.
Diazoxide or nitroprusside may be prescribed if hypertension
is extremely severe and intensive care is necessary.
Blood pressure should be checked at regular intervals (as
recommended by the health care provider) to monitor condition.
Frequent blood pressure measurements performed at home are
often recommended for patients who have difficult-to-control
high blood pressure. Diabetes
and other conditions that increase the risk of heart disease
should be carefully controlled.
Lifestyle changes may be recommended, including weight
loss, exercise, dietary
adjustments to modify salt intake and/or consumption of saturated
fats. If you smoke, stop
smoking. Reduce or avoid
consumption of alcohol. These habits greatly add to the effects
of hypertension in causing heart disease.
Expectations (prognosis):
The extent of left ventricle enlargement is an indication
of the risk for complications. Treatment of hypertension
may reduce the amount of left ventricle damage. Recent studies
have shown that certain medications such as the ACE inhibitors,
beta-blockers, and the diuretic spironolactone can reverse
left ventricular hypertrophy and/or prolong survival in patients
with heart failure from hypertensive heart disease.
This disease can lead to sudden death.
Complications:
Calling your health care provider:
Call your health care provider if hypertension
has been diagnosed and symptoms develop.
References:
Packer M, Bristow MR, Cohn JN, et al for the
US Carvedilol Heart Failure Study Group. The effect of carvedilol
on morbidity and mortality in patients with chronic heart
failure. N Engl J Med 1996; 334:1349.
MERIT-HF Study Group. Effect of metoprolol
CR/XL in chronic heart failure: Metoprolol CR/XL Randomised
Intervention Trial in Congestive Heart Failure (MERIT-HF).
Lancet 1999; 353:2001.
Pitt B, Zannard F, Remme WJ, et al. The effect
of spironolactone on morbidity and mortality in patients with
severe heart failure. N Engl J Med 1999;341:709.
Updated Date: 05/08/00
Updated by: Thomas O. Staiger, MD Assistant
Professor of Medicine, Division of General Internal Medicine,
University of Washington School of Medicine
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