Heart failure is a condition in which the heart is unable to pump enough blood to meet the body’s needs. It is a serious condition that affects over 6 million adults in the United States. Identifying the leading causes of heart failure is important for prevention and treatment efforts. After coronary artery disease, the number one cause of heart failure is hypertension, also known as high blood pressure. Hypertension damages the heart over time, leading it to become enlarged and weakened. Controlling high blood pressure through lifestyle changes and medication can significantly reduce one’s risk of developing heart failure.
What is heart failure?
Heart failure refers to the heart’s inability to pump enough blood to meet the body’s demands. This can occur on the left side of the heart, where oxygen-rich blood is pumped from the lungs to the rest of the body. It can also occur on the right side of the heart, where deoxygenated blood is pumped from the body back to the lungs. The most common type of heart failure is left-sided heart failure. When the left ventricle cannot effectively pump blood, it backs up into the lungs and causes shortness of breath, fatigue, and swelling in the legs and abdomen. Right-sided heart failure also leads to fluid buildup, typically in the legs and abdomen.
What causes heart failure?
There are several conditions and factors that can damage the heart over time and cause heart failure:
– Coronary artery disease – narrowing of the arteries that supply blood to the heart muscle. This is the most common cause of heart failure.
– High blood pressure – forces the heart to work harder over time, leading to thickening and stiffening of the heart muscle. This is the number one cause of heart failure.
– Heart attack – damage to the heart muscle from a blocked artery prevents the heart from pumping normally.
– Cardiomyopathy – diseases of the heart muscle, including idiopathic, hypertrophic, and dilated cardiomyopathy. These make the heart pump less efficiently.
– Heart valve problems – faulty heart valves don’t allow proper blood flow and force the heart to overwork.
– Arrhythmias – abnormal heart rhythms such as atrial fibrillation can weaken the heart over time.
– Viral infections – viruses like HIV, coxsackievirus, and hepatitis C can inflame and weaken the heart muscle.
– Alcohol abuse and drug use – toxic effects of substances damage the heart.
– Diabetes – high blood sugar levels damage blood vessels and lead to accelerated cardiovascular disease.
How does high blood pressure cause heart failure?
High blood pressure, also called hypertension, is the number one risk factor for heart failure. When blood pressure is elevated for a prolonged period, it puts extra strain on the heart and damages the blood vessels. Here’s how uncontrolled high blood pressure leads to heart failure:
– The heart has to pump harder against the higher pressure in the circulatory system. This causes the muscular walls of the left ventricle to thicken in order to pump more forcefully.
– The thicker heart muscle becomes rigid and less efficient at pumping. This process is called left ventricular hypertrophy.
– The higher force needed for pumping also leads to enlargement of the left ventricle chamber. This is called dilatation.
– Over time, the overworked and enlarged heart muscle weakens and is unable to supply the body’s tissues with enough blood. This manifests as heart failure symptoms.
– High blood pressure damages the lining of the blood vessels, leading to atherosclerosis. This buildup of plaque narrows the arteries supplying blood to the heart muscle.
– The lack of blood flow can then cause a heart attack, which further reduces the pumping ability of the heart.
Statistics on high blood pressure and heart failure
Here are some key statistics that demonstrate the strong link between high blood pressure and heart failure:
| 75% of people with heart failure have a history of high blood pressure |
| High blood pressure increases heart failure risk by 200% |
| 1 in 3 adults have high blood pressure, putting them at greater risk |
| Only about half of people with high blood pressure have it under control |
These numbers show just how vital controlling blood pressure is for preventing heart failure down the line. With high blood pressure so widespread, increased screening and treatment efforts are needed.
How is high blood pressure diagnosed?
Doctors diagnose high blood pressure based on consistent elevated readings at medical appointments. Home monitoring can also detect high blood pressure. The new 2017 ACC/AHA guidelines define high blood pressure as:
– Normal: Less than 120/80 mm Hg
– Elevated: Systolic between 120-129 and diastolic less than 80
– Stage 1: Systolic between 130-139 or diastolic between 80-89
– Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg
– Hypertensive crisis: Systolic over 180 and/or diastolic over 120
The risk of heart disease and stroke doubles with every increment of 20/10 mm Hg starting at 115/75 mm Hg. People with elevated or stage 1 high blood pressure often have no symptoms, which is why routine screening is important.
How to prevent and treat high blood pressure
Here are some tips for preventing high blood pressure or keeping it under control:
– Maintain a healthy weight for your height.
– Exercise regularly with cardio and strength training.
– Follow a nutritious diet low in sodium, saturated and trans fat.
– Limit alcohol to moderate levels at most.
– Don’t smoke and avoid secondhand smoke.
– Manage stress through relaxation techniques.
– Monitor your blood pressure regularly.
Medications for high blood pressure include:
– Diuretics to lower blood volume.
– ACE inhibitors and ARBs to relax blood vessels.
– Beta-blockers to reduce heart rate.
– Calcium channel blockers to relax blood vessels.
Lifestyle changes enhance the effects of medications. Most people need lifelong treatment to control high blood pressure.
Conclusion
In summary, the number one cause of heart failure is high blood pressure or hypertension. Uncontrolled high blood pressure damages the heart over time, leading it to become overworked and inefficient at pumping blood. Hypertension accounts for 75% of heart failure cases. Lowering high blood pressure through healthy lifestyle habits and medication as needed is critical for preventing heart failure. Routine blood pressure screening, education and treatment adherence are key public health priorities for reducing the burden of heart failure.