Ronin Institute, Montclair, NJ, USA.
Framingham Heart Study, 73 Mt. Wayte Avenue, Suite 2, Framingham, MA, 01702, USA.
Curr Hypertens Rep. 2020 Feb 3;22(2):11. doi: 10.1007/s11906-020-1017-9.
Given that the life expectancy and the burden of hypertension are projected to increase over the next decade, hypertensive heart disease (HHD) may be expected to play an even more central role in the pathophysiology of cardiovascular disease (CVD). A broader understanding of the features and underlying mechanisms that constitute HHD therefore is of paramount importance.
HHD is a condition that arises as a result of elevated blood pressure and constitutes a key underlying mechanism for cardiovascular morbidity and mortality. Historically, studies investigating HHD have primarily focused on left ventricular (LV) hypertrophy (LVH), but it is increasingly apparent that HHD encompasses a range of target-organ damage beyond LVH, including other cardiovascular structural and functional adaptations that may occur separately or concomitantly. HHD is characterized by micro- and macroscopic myocardial alterations, structural phenotypic adaptations, and functional changes that include cardiac fibrosis, and the remodeling of the atria and ventricles and the arterial system. In this review, we summarize the structural and functional alterations in the cardiac and vascular system that constitute HHD and underscore their underlying pathophysiology.
鉴于未来十年预期高血压患者的预期寿命和负担将会增加，高血压性心脏病（HHD）在心血管疾病（CVD）的病理生理学中可能会发挥更核心的作用。因此，更广泛地了解构成 HHD 的特征和潜在机制至关重要。
HHD 是一种由血压升高引起的疾病，是心血管发病率和死亡率的关键潜在机制。从历史上看，研究 HHD 的主要重点是左心室肥厚（LVH），但越来越明显的是，HHD 除了 LVH 之外还包括一系列靶器官损伤，包括可能单独或同时发生的其他心血管结构和功能适应性改变。HHD 的特征是微观和宏观心肌改变、结构表型适应以及包括心脏纤维化在内的功能变化，以及心房和心室以及动脉系统的重塑。在这篇综述中，我们总结了构成 HHD 的心脏和血管系统的结构和功能改变，并强调了其潜在的病理生理学。
