Hypertensive heart disease 14/02/2022 q Hypertensive heart disease (HHD) is a consequence of the increased demands placed on the heart by hypertension, (Long standing) causing pressure overload and left ventricular hypertrophy q Even mild hypertension (blood pressure higher than 140/90 mmHg) of sufficient duration may induce hypertensive heart disease. q It is the second most common form of heart disease after IHD. hypertension predisposes to atherosclerosis. Therefore, most patients of hypertensive heart disease have advanced coronary atherosclerosis and may develop progressive IHD. q Hypertrophic adaptive response of the heart, which can progress: • Myocardial dysfunction • Cardiac dilatation • CHF • Sudden death and lead to death . Hypertensive heart disease 14/02/2022 The criteria for the diagnosis of systemic hypertensive heart disease are (1) left ventricular hypertrophy(LVH) in the absence of other cardiovascular pathology (e.g., valvular stenosis) (2) a history or pathologic evidence of hypertension. PATHOGENESIS. The Pathogenesis of left ventricular hypertrophy (LVH). Both genetic and haemodynamic contribute to LVH. The stress of pressure overload due to HTN on the ventricular wall causes increased production of myofilaments, myofibrils, Since the adult myocardial fibres do not divide, the fibres are hypertrophied---lead to increase the thickness of the LV wall.