Three‑year survival of patients with chronic systolic heart failure due to hypertension: analysis of prognostic factors.

543 INTROduCTION Despite advances in the diagno‐ sis and treatment of coronary artery disease and arterial hypertension, the incidence and preva‐ lence of chronic systolic heart failure (CHF) are still on the rise.1‐3 In people aged from 35 to 64 years, arterial hypertension causes a 4‐fold in‐ crease in the risk of CHF; in elderly patients, the increase is 2‐fold.4,5 Disorders of the circadian rhythm of arterial pressure, such as the absence of night‐time dip, are associated with a 2‐fold in‐ crease in CHF risk.6 Hypertension leads to left ventricular (LV) overload and to alterations in cardiac structure and function, referred to as hypertensive heart disease.7,8 The left ventricle adapts its size and shape to an increased afterload, which requires a greater energy input so as to maintain its car‐ diac output. Macro‐ and microangiopathy‐related ischemia as well as fibrosis additionally impair the ventricular function. Excessive activation of the neurohormonal system maintains the faulty cycle of remodeling, thereby causing further pro‐ AbsTRACT