The Concept of CMR

Complications of Hypertension

Hypertension is one of the most important modifiable risk factors for coronary heart disease, stroke, congestive heart failure, renal disease, and peripheral vascular disease. Arterial BP is a product of cardiac output and systemic vascular resistance. A number of factors modulate BP for adequate tissue perfusion, including humoral mediators, vascular reactivity, circulating blood volume, vascular calibre, blood viscosity, cardiac output, blood vessel elasticity, and neural stimulation (5). Although genetics appears to play a role in essential hypertension, the exact mechanism has not been established. Uncontrolled and prolonged elevation of BP can cause adverse changes to cardiac structure and function in two ways: directly by increased afterload and indirectly by associated neurohormonal and vascular changes. Accordingly, hypertension can damage various organs of the cardiovascular and central nervous system and is a frequent cause of renal disease.

Cardiac involvement in hypertension manifests as left ventricular hypertrophy, left atrial enlargement, aortic root dilatation, atrial and ventricular arrhythmias, systolic and diastolic heart failure, and ischemic heart disease (IHD) (5). Cerebrovascular manifestations include hemorrhagic and atheroembolic stroke or encephalopathy (5). Nephrosclerosis and microalbuminuria are also some of the possible complications of long-standing hypertension in the kidney (5).