An expert opinion on heart failure in hypertensive heart disease

There is strong evidence that hypertension is a major risk factor for heart failure (HF). Hypertension contributes to incident HF through direct and indirect effects. Indirect effects are consequences of ischaemic heart disease because hypertension facilitates atherosclerotic obstructive coronary artery disease. The direct effects are straightly related to hypertensive heart disease (HHD). Hypertensive heart disease poses a significant challenge with substantial medical and public health implications. Efforts should be made to recognize and manage HHD in a timely manner and optimize hypertension treatment. Reducing blood pressure (BP) and/or reassessing antihypertensive therapy using traditional or novel approaches can halt or delay progression to HF in patients with HHD and possibly prevent it. However, HHD's importance as a risk factor for overt HF is often overlooked in clinical practice. This document aims to summarize the current understanding of the burden of HHD and its risk for incident HF, discuss the mechanisms underlying HHD-related HF onset and progression, consider how diagnostic tools contribute to individualized phenotyping and HF risk stratification of HHD, address how therapeutic measures ameliorating or even preventing structural and functional alterations of HHD, along with BP control influence HHD-associated HF risk.

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Publication Details

Journal
European Journal of Heart Failure
Published
2026-01-07
DOI
https://doi.org/10.1093/ejhf/xuag004
Primary Topic
Cardiovascular Disease and Adiposity
Type
article
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article

An expert opinion on heart failure in hypertensive heart disease

B LOPEZ, B. Pitt, P. Verdecchia, Cesare Cuspidi et al.
European Journal of Heart Failure
Cardiovascular Disease and Adiposity
article

An expert opinion on heart failure in hypertensive heart disease

B LOPEZ, B. Pitt, P. Verdecchia, Cesare Cuspidi, Luke J. Laffin, Tazeen H. Jafar, Giovanni de Simone, D A Aune, Javier Muñiz Sáenz Diez, Miquel Camafort, C Y Chin, Arantxa González, Susana Ravassa, Marco Metra, Thomas H Marwick, Franz H Messerli, Faiez Zannad, Javed Butler, Giuseppe M Rosano, Marijana Tadic, Arthur Mark Richards, Jian Zhang, Annet Kirabo, Massimo Piepoli, Michael Böhm
article en

Abstract

There is strong evidence that hypertension is a major risk factor for heart failure (HF). Hypertension contributes to incident HF through direct and indirect effects. Indirect effects are consequences of ischaemic heart disease because hypertension facilitates atherosclerotic obstructive coronary artery disease. The direct effects are straightly related to hypertensive heart disease (HHD). Hypertensive heart disease poses a significant challenge with substantial medical and public health implications. Efforts should be made to recognize and manage HHD in a timely manner and optimize hypertension treatment. Reducing blood pressure (BP) and/or reassessing antihypertensive therapy using traditional or novel approaches can halt or delay progression to HF in patients with HHD and possibly prevent it. However, HHD's importance as a risk factor for overt HF is often overlooked in clinical practice. This document aims to summarize the current understanding of the burden of HHD and its risk for incident HF, discuss the mechanisms underlying HHD-related HF onset and progression, consider how diagnostic tools contribute to individualized phenotyping and HF risk stratification of HHD, address how therapeutic measures ameliorating or even preventing structural and functional alterations of HHD, along with BP control influence HHD-associated HF risk.

European Journal of Heart Failure
Jagiellonian University (PL), Cleveland Clinic (US), Baker Heart and Diabetes Institute (AU), Vita-Salute San Raffaele University (IT), OsloMet – Oslo Metropolitan University (NO), University of Milan (IT), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Cornell University (US), University of Michigan (US), Instituto de Salud Carlos III (ES), Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (ES), European Society of Hypertension (IT), San Raffaele University of Rome (IT), University of Mississippi (US), Menzies School of Health Research (AU), Universitätsklinikum des Saarlandes (DE), Presbyterian Hospital (US), IRCCS Policlinico San Donato (IT), Baylor Medical Center at Garland (US), Centre for Biomedical Network Research on Rare Diseases (ES), Navarre Institute of Health Research (ES), Michigan Medicine (US), Hospital Clínic de Barcelona (ES), Federico II University Hospital (IT), Luzerner Kantonsspital (CH), Duke-NUS Medical School (SG), Cancer Registry of Norway (NO), IRCCS Ospedale San Raffaele (IT), National Heart Centre Singapore (SG), University Hospital Ulm (DE), Fu Wai Hospital (CN), Medical Research Network (US), French Clinical Research Infrastructure Network (FR), Imperial College London (GB), Christ University (IN), University of Milano-Bicocca (IT), Misericordia University (US), University of Otago (NZ), Universidad de Navarra (ES), Vanderbilt University Medical Center (US)
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Openalex Percentile: Top 88%
Cardiovascular Disease and Adiposity
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