Introducing the Concept of Hypertensive Heart Disease to Improve Hypertensive Left Ventricular Hypertrophy

Abstract

Background: Among the organ damage mediated by hypertension, cardiac lesions hold significant importance. Numerous authors focus on hypertensive heart disease (HHD) rather than exclusively on left ventricular hypertrophy (LVH).

Objectives: This narrative review aims to assess the incorporation of the concept of 'hypertensive heart disease' (HHD) in hypertension (HTN) guidelines. Furthermore, if HHD is not addressed, the review will evaluate the potential benefits of including this concept in future studies.

Methods: The following databases were searched: Scopus, Medline, Springer, Science Direct, Wiley, SAGE, Cambridge, Oxford Journals, and Google Scholar. Attention was given to the guidelines related to hypertension (HTN); the search items were "guidelines" and "hypertension." Within these guidelines, we specifically sought references to 'hypertensive heart disease.'.

Results: The concept of "HHD" is clearly advantageous compared to "HTN LVH," as it not only addresses LVH but also considers other structures of the heart that may be severely affected, which can significantly influence treatment. The concept of "hypertensive heart disease" is mentioned in only 8 out of 36 guidelines on HTN. The therapeutic implications and recommendations are absent in the guidelines.

Conclusion: The concept of HHD is reasonable and evidence-based, and there is no reason to focus only on LVH when considering HTN-induced damage to the heart. It is time to update our recommendations for heart treatment by using the phrase "Treatment of hypertensive heart disease" instead of "Treatment of hypertensive LVH." This update can enhance our awareness of the need to improve not only HTN LVH but the other parts of the heart as well.

Keywords: Arterial hypertension; heart failure; hypertension-mediated organ damages; hypertensive heart disease; left atrium.; left ventricular hypertrophy.