M.A. Fortuño, G. Zalba, J.C. Etayo, A. Fortuño, J. Beaumont, S. Ravassa, A. González, J. Díez
Unidad de Fisiopatología Vascular, Facultad de Medicina, Universidad de Navarra.
Hypertensive cardiopathy constitutes the principal complication of high blood pressure, as it is the first cause of morbi-mortality of the hypertense patient. In arterial hypertension the histological composition of the left ventricle is globally altered, with lesions resulting that affect the cardiomyocites themselves, the miocardic interstitium and the wall of the intramyocardial arteries. Participating in the origin of the development of these lesions are both mechanical overload of the ventricular wall imposed by high arterial pressure, and systemic and local humoral factors that act directly on the parenchyma and the myocardial vessels, for example angiotensin II. The functional consequences of myocardial structural lesions are diverse, although the most representative is that which has to do with the development of congestive heart failure. The diagnosis of hypertensive cardiopathy requires the demonstration of disorders of the structure and/or the function of the left ventricle in the hypertense patient, which at the present time requires the realization of specialized studies. The present treatment of high blood pressure recognizes heart protection as one of its main objectives, that is the restoration of the structural and functional integrity of the left ventricle that minimizes cardiac risk in the patient, something that is not achieved by simply normalizing arterial pressure.
Key words: Hypertensive heart disease. High blood pressure. Heart failure. Renin-angiotensin system.