April 29, 2021Current Opinion in Cardiology32 citations
Interactions of hypertension, obesity, left ventricular hypertrophy, and heart failure
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Key Result
Weight loss and blood pressure control help to partially reverse maladaptive cardiac changes caused by obesity and hypertension, improving clinical outcomes in patients with heart failure.
Structured PICO
Does weight loss and blood pressure control improve cardiac remodeling and clinical outcomes in patients with hypertension, obesity, and heart failure?
P
Population
Patients with hypertension and obesity at risk for or with left ventricular hypertrophy (LVH) and heart failure (HF)
I
Intervention
Weight loss and blood pressure (BP) control
O
Outcome
Prevention and reversal of cardiac damage (LVH) and improvement in clinical outcomes in HF
Weight loss and blood pressure control can partially reverse maladaptive cardiac changes and improve clinical outcomes in patients with obesity, hypertension, and heart failure.
Abstract
PURPOSE OF REVIEW: Hypertension (HTN) and obesity are major risk factors for cardiac remodeling and dysfunction, leading to left ventricular hypertrophy (LVH) and heart failure (HF). In this review, we discuss the complex mechanisms and effects of HTN and obesity, and their treatments in LVH, ventricular function, and HF. RECENT FINDINGS: Obesity and HTN impact the heart through overlapping neurohormonal pathways. However, the relationship between obesity and cardiomyopathy is more complex, and additional metabolic and hemodynamic pathways seem to contribute to cardiac dysfunction in these patients. Weight loss and blood pressure (BP) control help to prevent and reverse at least some of the damage caused by obesity and HTN even beyond what would be expected from solely the hemodynamic changes. SUMMARY: Obesity and HTN cause maladaptive changes in the heart that can lead to LVH and HF. Weight loss and BP control help to, at least partially, reverse some of these changes and improve clinical outcomes in patients with HF.