Document Detail

Hypertension and diastolic heart failure.
MedLine Citation:
PMID:  19863866     Owner:  NLM     Status:  In-Process    
In patients with hypertension, pressure overload leads to left ventricular hypertrophy (LVH), myocardial fibrosis, and impaired diastolic filling without systolic dysfunction. Presently, diastolic heart failure accounts for about 50% of the heart failure population. Fatigue, dyspnea, reduced exercise tolerance, and peripheral edema are common presenting complaints. As a group, patients with diastolic heart failure are older and predominantly female. Diuretics are effective for treating congestive symptoms. beta Blockers and heart rate-lowering calcium blockers show benefit in smaller studies but have not been evaluated in definitive clinical trials. Renin-angiotensin-aldosterone system blockers reduce blood pressure, LVH, and myocardial fibrosis; however, long-term studies with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers demonstrate little effect on symptoms or survival, and inconsistent effects on heart failure hospitalization. At present, evidence-based treatment includes antihypertensive therapy to reduce progression from hypertension to heart failure. In patients with established heart failure, diuretics and other empiric treatments are used to control symptoms.
Alan H Gradman; J Travis Wilson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current cardiology reports     Volume:  11     ISSN:  1534-3170     ISO Abbreviation:  Curr Cardiol Rep     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888969     Medline TA:  Curr Cardiol Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-9     Citation Subset:  IM    
Division of Cardiovascular Disease, The Western Pennsylvania Hospital-Suite 3411 NT, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA.
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