Why the study?
The pathophysiological mechanisms linking hypertension to left ventricular hypertrophy and chronic heart failure, along with diagnostic and therapeutic issues in heart failure with preserved ejection fraction, require review.
This review highlights the pathophysiological progression from hypertension to left ventricular hypertrophy and chronic heart failure, emphasizing the ongoing need for effective treatments for HFpEF.
Objective . The purpose of this review is to highlight the pathophysiological mechanisms of the sequential formation of left ventricular hypertrophy (LVH), left ventricular dysfunction and chronic heart failure (CHF) in patients with hypertension (HTN), diagnostic and therapeutical issues of CHF with both reduced and preserved ejection fraction (EF). HTN is the main risk factor for cardiovascular diseases and is accompanied by damage of target organs, among which LVH is of particular importance. On the one hand, development of LVH is the consequence of increased load on the heart muscle and neurohumoral stimuli, and on the other hand, it is an independent risk factor for myocardial infarction, stroke, cardiac arrhythmias and CHF. HTN precedes newly developed heart failure in 91 % of patients with a predominance of CHF with a preserved EF according to the Framingham Heart Study. To date, different drugs can improve the prognosis of patients with HTN, CHF with reduced EF and to induce LVH regression. However, the issues of effective treatment of patients with CHF with preserved EF are still insufficiently studied.
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Семенкин et al. (2023) studied this question.
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