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May guide integrated hypertension-heart disease care; leaves open prospective trials to validate targeted interventions.
The interactions linking high blood pressure with hypertensive heart disease are reciprocal. Hypertension can be regarded as a source of adverse effects on myocardial structure and function by favoring the development and progression of left ventricular hypertrophy and of left ventricular dysfunction and failure in the advanced phases of the disease. Conversely, the heart can be regarded as a source of reflex influences on the cardiovascular system, which appear to be deranged in the hypertensive state. The clinical relevance of this reflex dysfunction is based on the evidence that these alterations may favor the occurrence of an increased sympathetic vasoconstrictor drive, thereby promoting the development of the1 hypertensive state. Both phenomena have important clinic and therapeutic implications potentiating the cardiovascular risk profile of the hypertensive patient.
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Mancia et al. (2006) studied this question.
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