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The invisible threat of high blood pressure: How does it become a major driver of heart failure?
High blood pressure, often seen as an invisible health risk, is increasingly being linked to heart failure. Heart failure is a series of health problems caused by the inability of the heart to pump blood effectively, among which heart failure with preserved ejection fraction (HFpEF) is increasingly becoming the focus of research. According to some surveys, nearly half of heart failure patients are of HFpEF type, and hypertension is one of its major risk factors. In this article, we will explore how hypertension contributes to the development of HFpEF and how patients can cope with it.
What is HFpEF?
The ejection fraction in heart failure refers to the percentage of the maximum filling volume of blood that is ejected from the left ventricle in each heartbeat. If the ejection fraction is greater than 50%, it can be diagnosed as HFpEF. This condition is usually accompanied by abnormal left ventricular diastolic function, which prevents the heart from relaxing effectively during diastole, thus affecting the overall function of the heart.
Common clinical manifestations of HFpEF patients include shortness of breath, poor exercise tolerance, fatigue, increased jugular venous pressure and edema.
The role of high blood pressure
The development of hypertension can lead to increased left ventricular afterload and subsequent structural changes, ultimately leading to HFpEF. When the heart is faced with continuous high pressure, the left ventricular muscle will gradually thicken, forming concentric hypertrophy, which further impairs the heart's diastolic function.
Other risk factors
In addition to hypertension, obesity, diabetes, hyperlipidemia, and sleep apnea are also associated with HFpEF. These conditions not only cause changes in the structure of the heart, but may also lead to changes in the heart's microvasculature, further increasing the burden on the heart.
Clinical manifestations of heart failureThe clinical presentation of patients with HFpEF is similar to that of patients with HFrEF, but patients with HFpEF are often quite sensitive to stress applied to the heart. This means that they often show a significant decrease in exercise tolerance during exercise or other activities that require increased cardiac output.
Many patients with HFpEF are unable to increase their heart rate in response to increased demand, a condition known as "rate failure."
Influence Mechanism
Multiple mechanisms may be involved in the development of HFpEF. Studies have shown that insulin resistance may have a direct impact on the occurrence of HFpEF, which can trigger a persistent inflammatory state and further change the cardiovascular endothelium.
The effects of aging and menopause
With aging, the quality of the heart declines, a process that bears striking resemblance to the clinical presentation of HFpEF. Furthermore, as women enter menopause, declining estrogen levels are thought to increase the risk of HFpEF.
In patients with HFpEF, the incidence of pulmonary hypertension is significantly increased, which is associated with high morbidity and mortality.
Approach to diagnosing HFpEF
HFpEF is usually diagnosed by cardiac ultrasound. This test is able to assess the heart's diastolic function and provide details that shed light on a patient's heart health.
Coping strategies
One of the most effective ways to prevent HFpEF is through lifestyle changes, including eating a balanced diet, getting regular exercise, and managing stress. Appropriate exercise can help improve cardiovascular health and further reduce the risk of HFpEF.
Finally, we should pay attention to the impact of high blood pressure on heart health and ask ourselves, how can we avoid the impact of this invisible threat in our daily lives?
