Transition to heart failure in hypertension: going to the heart of the matter

This editorial refers to ‘Low coronary flow relative to myocardial mass predicts heart failure in symptomatic hypertensive patients with no obstructive coronary artery disease’, by J.M. Brown et al., doi:10.1093/eurheartj/ehab610. Heart failure (HF) affects up to one in five adults during their lifetime and is associated with considerable mortality and morbidity, despite advances in management. Although most of the burden of HF is borne by people aged 65 years or over, recent reports show an increase in the incidence of HF particularly among younger people. In this regard, a recent study1 to assess age differences in risk factors for incident HF in the general population reported that hypertension was associated with a three-fold increase in risk of future HF [both HF with reduced ejection fraction (HFrEF) and HF with preserved EF (HFpEF)] in young participants (<55 years) compared with a 1.4-fold risk in elderly participants (>65 years),...