The relationship between heart and the blood circulation is analogous to central pumping station of water supply and the distribution system. Whenever multiple blocks develop in the distribution system, the central pumping station or the heart in a human body is affected. The normal size of the heart is equivalent to a closed fist. The normal thickness of the walls of the heart is 6 to 11 mm depending on age and gender. When the thickness is more on the left side it is called left ventricular hypertrophy (LVH) and vice versa. Normal weight of the heart ranges from 200 to 400 grams depending on the gender and body surface area. When the weight is more, it is called increased left ventricle mass.
Whenever the blood pressure remains elevated for more than six months, the heart muscles start showing LVH or increased left ventricle mass. This is exactly like the prominent muscles seen in persons performing regular weight lifting. Structural and biological changes in the heart resulting from high blood pressure are encompassed by the term ‘hypertensive heart disease’.
Untreated high blood pressure is related to LVH, increase in LV mass, heart failure, cardiac rhythm disturbances, ischemic heart (coronary) disease and sudden death. LVH or high left ventricle mass is a result of the increase in the work burden of heart muscle cells. The cell becomes larger. Increased thickness results in impaired relaxation of the heart muscle. Heart muscles become stiff. As a result, the physiological low blood pressures inside the heart chambers become high.
“One experiences difficulty in climbing up or walking fast. This may lead to a type of heart failure called heart failure with preserved systolic function. The pumping is fine, only the filling is abnormal. Gradually, the pumping function also becomes abnormal and we call it heart failure with reduced systolic function. Heart failure risk is 10 times in hypertension with LVH,” explains Dr Tapan Ghose, director and head, cardiology and director clinical research and academics, Fortis Flt Lt Rajan Dhall Hospital, Vasant Kunj.
Some individuals develop extra beats which are felt like a thump or missing beats. Sometimes the upper chamber (atrium) enlarges which results in irregular heart rhythm (atrial fibrillation). This can cause formation and dislodgement of blood clot from the upper chamber of the heart and blockage in the blood supply of any part of the brain. This results in a stroke.
Coronary artery disease (CAD) develops in patients with hypertension at a frequency which is two times more than the general population. Silent heart attack, a larger size of heart damage and higher complications are seen in hypertension with CAD.
Hypertension causes an accelerated rate of arterial blockage. The flow of blood is also abnormal. Hypertension increases the risk of sudden death by 2.5 times. This is mainly due to the higher incidence of Coronary artery disease (acute heart attack) which results in fatal arrhythmia.
The good part is, it’s a preventable illness. Both non-drug therapy and drug therapy in consultation with a physician help control blood pressure. However, one must understand that this is not a curable illness. BP should be treated to the target range. Good control of blood pressure will prevent or reverse many changes in the heart. This will reduce stroke, heart failure hospitalisation and death.
Our ultimate aim should be to avoid high blood pressure development (primordial prevention).
Here are a few tips:
1. No extra salt in diet.
2. Consume 600 gms of fruits and vegetables daily
3. Maintain ideal body weight
4. Moderate intensity exercise daily for 30-35 minutes along with yoga and meditation is recommended
5. Sleep seven hours daily
6. Don’t make stress a habit
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