Contemporary Diagnosis and Management of Hypertensive Heart Disease

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Acquired Cardiovascular Disease".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 3135

Special Issue Editor


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Guest Editor
Division of Cardiology, Bronx Care Health System,1650 Grand Concourse, Bronx, NY 10457, USA
Interests: aortic aneurysm; aortic valve disease; cardiomyopathies; congestive heart failure; coronary heart disease; echocardiography; hypertensive heart disease; mitral valve disease
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Special Issue Information

Dear Colleagues,

Hypertensive heart disease refers to a cluster of structural and functional changes in the left ventricle, left atrium, and coronary arteries as a result of chronic hypertension. Chronic elevated blood pressure increases the cardiac workload, resulting in left ventricular hypertrophy and/or fibrosis. It has been well established that left ventricular hypertrophy in patients with hypertension is associated with increased cardiovascular morbidity and mortality. Current treatment follows standard hypertension guidelines for blood pressure control as even the effects of pharmacotherapy on regression of left ventricular hypertrophy are beneficial. While elevated blood pressure is a risk factor for hypertensive heart disease, only a small proportion of the variability in hypertensive heart disease can be explained by blood pressure alone. Other risk factors include older age, ethnicity, overweight status, physical inactivity, excess salt intake, smoking, alcohol, diabetes mellitus, and genetic predisposition. Clinical and hemodynamic stimuli to hypertensive heart disease induce fundamental reconfigurations of the molecular, cellular, and protein components of the endothelium and myocardium. A diagnosis of hypertensive heart disease is established using noninvasive cardiac imaging. Managing hypertensive heart disease is a multi-disciplinary approach that includes lifestyle modification, pharmacotherapy, and management of its complications including heart failure, atrial fibrillation, and coronary artery disease.

Dr. Jonathan Bella
Guest Editor

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Keywords

  • hypertension
  • left ventricular hypertrophy
  • prognosis
  • genetics
  • echocardiography
  • non-invasive cardiac imaging
  • hypertension treatment
  • atrial fibrillation
  • heart failure
  • coronary artery disease

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Published Papers (1 paper)

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Review

19 pages, 880 KiB  
Review
Diagnosis and Management of Hypertensive Heart Disease: Incorporating 2023 European Society of Hypertension and 2024 European Society of Cardiology Guideline Updates
by Brian Xiangzhi Wang
J. Cardiovasc. Dev. Dis. 2025, 12(2), 46; https://doi.org/10.3390/jcdd12020046 - 26 Jan 2025
Viewed by 2817
Abstract
Hypertensive heart disease (HHD) continues to be a leading cause of cardiovascular morbidity and mortality worldwide, necessitating the evolution of evidence-based management strategies. This literature review examines the most recent updates from the 2023 and 2024 hypertension guidelines issued by the European Society [...] Read more.
Hypertensive heart disease (HHD) continues to be a leading cause of cardiovascular morbidity and mortality worldwide, necessitating the evolution of evidence-based management strategies. This literature review examines the most recent updates from the 2023 and 2024 hypertension guidelines issued by the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). These guidelines are compared with previous key recommendations, such as the 2017 American College of Cardiology/American Heart Association guidelines and the 2018 ESC/ESH guidelines. The updated recommendations reflect a paradigm shift in the approach to hypertension diagnosis and management, including a stricter systolic blood pressure (BP) target of 120–129 mmHg, which underscores the importance of early and precise BP control. The difference between the classification of “elevated BP” and hypertension in the ESC versus ESH guidelines, particularly, regarding their implications for early detection and prevention of HHD, are critically examined, highlighting areas of clinical and academic debate. The introduction of a new “elevated BP” category (120–139/70–89 mmHg) highlights a proactive strategy aimed at identifying at-risk individuals earlier in the disease course to prevent progression to HHD. Additionally, the divergent roles of hypertension-mediated organ damage (HMOD), including HHD, in risk stratification as recommended by the ESC and ESH are discussed, emphasising their significance in tailoring management approaches. For patients with resistant hypertension, the 2023 and 2024 updates also endorse innovative therapies, such as renal denervation, an interventional procedure that has demonstrated significant promise in managing treatment-resistant cases. This review synthesises these updates, focusing on their implications for clinical practice in diagnosing and managing HHD. By emphasising aggressive intervention and the integration of novel treatment modalities, the review aims to bridge existing gaps in earlier approaches to hypertension management. The critical evaluation of guideline discrepancies and evolving evidence seeks to provide clinicians with a nuanced understanding to optimise outcomes for patients with HHD, particularly considering emerging therapeutic possibilities and more stringent BP control targets. Full article
(This article belongs to the Special Issue Contemporary Diagnosis and Management of Hypertensive Heart Disease)
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