Diabetic vascular diseases: molecular mechanisms and therapeutic strategies
High Blood Pressure And Hypertensive Heart Disease
Your heart beats around 100,000 times every day. Every minute, it pumps nearly 1.5 gallons of blood. But there are a lot of reasons why this crucial organ can stop working properly. One of those is chronic hypertension, or what you might know as ongoing high blood pressure.
"Hypertensive heart disease is a condition where the heart muscle can get damaged over time due to long-standing high blood pressure," says Joy Gelbman, MD, a cardiologist at Weill Cornell Medicine and New York-Presbyterian. "The heart can become big, thickened or weakened due to pumping against a high blood pressure over a long time."
Keeping your blood pressure under control is critical to managing hypertensive heart disease.
About 1 out of 3 Americans have high blood pressure (higher than 120/80). Only half of these cases are managed well.
You won't be able to feel if blood is pushing against the walls of your arteries with too much force. That's why high blood pressure is sometimes called a "silent killer." But over time, hypertension can make it harder for your heart to pump enough blood. It can also damage or narrow your blood vessels. That can become an even bigger issue if you also have high cholesterol. Cholesterol is a fatty substance that can clog the pathways through which blood flows in your body.
Usually, chronic hypertension happens because of several different factors. These can include:
High blood pressure that isn't treated for a long time can lead to hypertensive heart disease (HTN heart disease.) You could be at a higher risk if:
Hypertension puts extra strain on your heart, which may cause it to weaken and become stiff. Over time, it can begin to fail.
If your arteries become so damaged that enough blood can't reach your heart, you could have a condition called ischemic heart disease (IHD).
You might not have any symptoms until some damage has been done to your heart. The signs of hypertensive cardiovascular disease include:
Your doctor will ask about your family history of heart issues, and check your blood pressure. If you're on medication for high blood pressure, they'll likely ask if you're taking your medication as prescribed and if you are checking your blood pressure at home. If so, your doctor will want to know some of your recent readings.
They'll also ask about any symptoms you're having. During a physical exam, your doctor can listen to your heart. They'll likely also order some tests, including:
"When you're diagnosed with hypertensive heart disease, there are still measures you can take to prevent further complications," says Carmen W. Landrau, MD, a cardiologist and spokesperson for the American Heart Association.
The first step in treating hypertensive cardiovascular disease is treating the high blood pressure that's causing it. That can be done in several ways, including prescribed medications and making small changes to your daily habits.
Medications for hypertensive heart disease
Many different treatments can help manage your blood pressure. They work by relaxing or widening your blood vessels, helping to flush excess fluid from your body, or slowing down your heart rate so your heart doesn't have to work as hard. Your doctor could prescribe:
Lifestyle changes for hypertensive heart disease
Your doctor may also advise you to make changes to your lifestyle. You can:
Make healthy food choices. That includes limiting the amount of sodium and saturated fats you eat. Fill your plate instead with more fruits, vegetables, whole grains, and low-fat dairy.
More physical activity. Working out helps control your blood pressure, maintains your heart function, and helps you reach and stay at a healthy weight.
Avoid tobacco products and alcohol. If you need help quitting, ask your doctor for tips.
Get regular checkups. During follow-up visits, your doctor can make sure you and your heart are staying healthy.
Manage your stress level. Feeling anxious can raise your blood pressure.
Surgeries for hypertensive heart disease
If your condition doesn't get better with medication and lifestyle changes, your doctor may talk to you about a medical procedure.
For instance, an FDA-approved procedure called renal ablation, or renal denervation, helps some people who have resistant hypertension.
During this minimally invasive surgery, a cardiologist uses ultrasound or radiofrequency energy to damage the renal nerves in your kidneys. Making these nerves less active can help control your blood pressure.
Other types of surgeries can help strengthen your arteries or repair or replace damaged parts of your heart. Your doctor can explain which kind of surgery is right for you.
Getting and keeping your blood pressure under control can reduce your chances of more severe heart issues.
Heart failure
Heart failure, or congestive heart failure, doesn't mean your heart stops working. It means that your heart's pumping power is less than it should be. With heart failure, blood doesn't move well through your heart's chambers, and pressure in your heart increases, making it harder for your heart to deliver oxygen and nutrients to your body.
At first, the chambers of your heart will stretch to try to keep blood moving. Your body will also try to adjust in other ways. For instance, your blood vessels will narrow to increase the force of blood flow. And your kidneys will retain more fluid (water) and sodium so there's a larger amount of blood in your body. But these are only short-term fixes.
Symptoms of heart failure include:
Ischemic heart disease (IHD)
When your arteries can no longer open wide enough to easily let blood through, your heart becomes damaged. One of the most common symptoms of ischemic heart disease is chest pain, or what's called angina.
Coronary artery disease (CAD)
This is another name for ischemic heart disease. You could also hear it called coronary heart disease.
Left ventricle hypertrophy (LVH)
High blood pressure makes your heart work harder than it should, which causes its walls to thicken. As a result, the left ventricle (pumping chamber) starts to get stiff and weak. That can prevent enough blood flow, although you may not have symptoms for many years.
Enlarged heart
Your doctor will be able to see this on an imaging test. An enlarged heart isn't a condition. But it is a sign that your heart is working harder than normal or has been damaged.
Stroke
A stroke happens when blood flow to your brain gets blocked. It's a medical emergency because your brain cells can start dying in minutes. Stroke symptoms include having trouble seeing, speaking, walking, or understanding others, numbness on one side of your body, or a sudden, severe headache. If you think you're having a stroke, call 911 right away. Don't wait to see if your symptoms get better or go away on their own.
Sudden cardiac arrest (SCA)
If your heart stops working because of an abnormal heart rhythm, you'll collapse and stop breathing. SCA is different from a heart attack, which happens when blood stops flowing to your heart. CPR can help get your heart started again. An electrical device called an automated external defibrillator (AED) can also shock your heart into pumping again.
To try to prevent hypertensive cardiovascular disease, you can:
Have regular checkups. Your blood pressure should be checked by your doctor at least once a year, more often if it's high.
Take care of any other health conditions. For instance, manage your blood sugar if you live with diabetes. If you know your cholesterol is high, make changes to your eating habits to try to bring it down.
Enjoy healthy meals. Try to eat fewer processed foods, as they're often high in sodium. Instead, look for fresh, flavorful recipes that fit into the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diets.
Get moving. When you work out regularly, you can lower your blood pressure by 5 to 8 points. Aim for about 30 minutes of physical activity every day, but even less than that is good for you. Every bit counts.
Quit tobacco and curb your alcohol intake. Doing so could not only lower your risk of hypertensive heart disease but also improve your overall health.
Don't skimp on sleep. Sleeping less than seven hours a night regularly can raise your blood pressure. If you have trouble sleeping, talk to your doctor.
Keep stress in check. You can't get rid of all the stress in your life, but you can get better at dealing with it. If you need new ways to manage stress, a counselor or therapist can help.
When high blood pressure goes untreated for a long time, it can damage your arteries and strain your heart. That can lead to hypertensive heart disease and other complications. While there's no cure, HTN heart disease can be managed with medications and lifestyle changes. See your doctor regularly. That way, they can track your blood pressure and work with you to get it in a healthy range.
How are hypertension heart disease and stroke related?
Most people who have a stroke also have high blood pressure. That's because weakened arteries are more likely to burst or get blocked. Managing your hypertension will help lower your risk of stroke.
What is stage A heart failure?
If you're at risk of heart failure but don't have any symptoms, doctors will say that you're in stage A heart failure. The factors that put you at risk include:
Can hypertensive heart disease be reversed?
Lifestyle choices often play a big role in hypertensive heart disease. You may see your blood pressure numbers improve when you watch what you eat, get regular exercise, quit tobacco use, and manage other ongoing health conditions such as diabetes. It will depend on how severe your condition is, but sometimes heart failure can also be reversed with treatments such as medication or surgery.
Surprising Heart Disease Symptoms You NEED To Know
Heart disease remains a leading cause of death worldwide, but the good news is that early detection and intervention can significantly improve outcomes. While classic heart disease symptoms like chest pain are well-known, your body often whispers subtler clues that something might be amiss with your cardiovascular health. Paying attention to these less obvious signals is paramount for proactive health management. Recognizing these diverse signals can empower you to seek timely medical attention and potentially prevent serious cardiac events.
What are the signs of heart disease in the face?While a flushed complexion after exercise is normal, certain facial features can sometimes hint at underlying cardiovascular issues. One notable sign is xanthelasma, characterized by yellowish, fatty deposits that appear on or around the eyelids. These plaques are often associated with elevated cholesterol levels, a significant risk factor for heart disease.
Additionally, some studies have explored a potential link between earlobe creases (specifically a diagonal crease on the earlobe, known as Frank's sign) and an increased risk of coronary artery disease, although this remains a topic of ongoing research and isn't considered a definitive diagnostic tool.
Furthermore, conditions causing facial swelling or discoloration could indirectly be related to heart problems affecting fluid balance and circulation, though these are less direct indicators. It's crucial to discuss any persistent or concerning facial changes with your doctor to determine the underlying cause.
RELATED: A Cardiologist Explains: The Silent Killers: Hypertension and Heart Disease in Black Folks
Beyond the typical chest pain, shortness of breath, and palpitations, heart disease can manifest in surprising and seemingly unrelated ways. Recognizing these uncommon symptoms can be crucial for early diagnosis:
RELATED: Science Says: 4 Natural Solutions For Erectile Dysfunction
1. Erectile Dysfunction (ED)Often considered a sensitive topic, ED can be an early indicator of underlying vascular disease. The arteries that supply blood to the penis are smaller than those supplying the heart, making them more susceptible to the effects of atherosclerosis (plaque buildup). Experiencing new-onset or worsening ED should prompt a discussion with your doctor about potential cardiovascular risk factors.
2. Excessive SnoringWhile occasional snoring is common, loud, disruptive snoring, especially when accompanied by pauses in breathing (sleep apnea), can put a strain on the cardiovascular system. Sleep apnea is linked to high blood pressure, irregular heartbeats, and an increased risk of heart attack and stroke.
3. Bleeding GumsEmerging research suggests a connection between gum disease (periodontitis) and heart disease. The chronic inflammation associated with gum disease may contribute to inflammation in other parts of the body, including the arteries. While more research is needed to fully understand this link, maintaining good oral hygiene is beneficial for overall health.
RELATED: 6 Heart Disease Symptoms Black Women Should Look For
4. Nausea, Indigestion, Heartburn, or Stomach PainWhile often attributed to digestive issues, pain or discomfort in the upper abdomen, particularly if accompanied by other symptoms like sweating or shortness of breath, can sometimes be a sign of a heart problem, especially in women. It's important not to dismiss these symptoms, especially if they are new or unusual.
5. Unexplained FatigueWhile everyone experiences tiredness, persistent and excessive fatigue that doesn't improve with rest can be a subtle sign of heart disease, particularly heart failure. This fatigue can be a result of the heart not pumping enough oxygen-rich blood to meet the body's needs.
6. Pain in the Jaw, Neck, Back, Arm, or ShoulderWhile chest pain is the classic symptom, pain radiating to these areas, especially during exertion, can also indicate a heart issue. This pain may not always feel sharp or intense but rather like pressure, tightness, or discomfort.
RELATED: What Is Coronary Heart Disease?
Coronary heart disease (CHD) is characterized by the buildup of plaque in the coronary arteries, which supply blood to the heart muscle. The immediate physical effects often arise when this plaque significantly narrows or blocks an artery, reducing blood flow. This can lead to:
It's important to remember that the severity and presentation of these immediate effects can vary greatly from person to person.
RELATED: 5 Heart Failure Symptoms Doctors Commonly Miss
What are the symptoms of heart failure fatigue?Heart failure occurs when the heart muscle is weakened or damaged and can't pump enough blood to meet the body's needs. Fatigue is a hallmark symptom of heart failure, but it differs from typical tiredness. Heart failure fatigue is often:
Understanding the nuances of heart failure fatigue is crucial for patients and their caregivers to manage the condition effectively and communicate changes to their healthcare providers.
ConclusionRecognizing the diverse and sometimes surprising physical signs of heart disease is a vital step toward protecting your cardiovascular health. From subtle facial indicators and uncommon symptoms like erectile dysfunction and bleeding gums to the more immediate effects of coronary artery disease and the debilitating fatigue of heart failure, your body provides clues. By being attentive to these signals and engaging in open communication with your doctor, you can facilitate earlier diagnosis, implement preventive measures, and ultimately improve your long-term heart health. Don't dismiss seemingly minor or unrelated symptoms – they could be your heart's way of asking for attention.
What Did Gene Hackman Die Of? Hypertensive Atherosclerotic Cardiovascular Disease Explained
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Gene Hackman's primary cause of death was due to hypertensive atherosclerotic cardiovascular disease — but what does the condition entail?
Hypertensive Atherosclerotic Cardiovascular Disease is a combination of hypertensive heart disease and arteriosclerosis. According to the Cleveland Clinic, hypertensive heart disease is a long-term condition that develops over time in patients who have high blood pressure — which is another name for hypertension. When unmanaged for a long period, it can lead to problems including heart failure and arrhythmias.
Arteriosclerosis occurs when a person's arteries become thick and stiff compared to the typically flexible and elastic consistency a healthy one, per the Mayo Clinic. The arteries' walls can harden over time. When the artery walls have a buildup of fats, cholesterol and other substances it results in plaque which can cause the vessels to narrow and block blood flow.
In most patients, a mild case of arteriosclerosis typically does not display symptoms. If the condition is detected early, doctors can typically prevent it from worsening into a heart attack or stroke. However, the disease slowly gets worse over time.
What to Know About Gene Hackman and Wife Betsy Arakawa's Death and Investigation
Oscar-winning actor Hackman's cause of death was revealed on Friday, March 7, in a press conference. In addition to hypertensive atherosclerotic cardiovascular disease, Alzheimer's disease was listed as a significant contributing factor to the actor's death. The medical examiner was not able to confirm if Gene died by a heart attack.
Alzheimer's disease is the buildup of proteins in the form of amyloid plaques and neurofibrillary tangles in the brain, per the Mayo Clinic. It is one of the most common causes of dementia which affects millions of adults above the age of 65. Symptoms of Alzheimer's disease include memory loss, trouble concentrating, changes in personality and more. There is no cure for the condition.
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Us Weekly confirmed on February 27 that Hackman and his wife, Betsy Arakawa, were found dead in their New Mexico home the day before. Hackman was 95 while Arakawa was 64. After news broke of Hackman and Arakawa's deaths, the couple were mourned by their loved ones.
"It is with great sadness that we announce the passing of our father, Gene Hackman and his wife, Betsy," Hackman's daughters, Elizabeth and Leslie, and granddaughter Annie said in a statement to Us at the time. "He was loved and admired by millions around the world for his brilliant acting career, but to us he was always just Dad and Grandpa. We will miss him sorely and are devastated by the loss."
Gene Hackman's Family Friends Claim the Actor's 'Health Was Slipping' Prior to His Mysterious Death
Shortly after news broke of the pair's death, an investigation took place. According to a police report obtained by TMZ, Arakawa was found lying unconscious next to a space heater and in an alleged "state of decomposition with bloating in her face and mummification in her hands and feet." Hackman was reportedly found in a separate room with some suspicion that he fell.
The Friday press conference revealed that authorities believe Hackman died on February 18, eight days before his body was discovered. It was also determined that Arakawa's cause of death was hantavirus pulmonary syndrome; she is believed to have died a week before her husband on February 11. Hackman and Arakawa's family was informed of the autopsy findings prior to the press conference.
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