Hypertension and the Heart and Vasculature

The importance of the heart as a target for end-organ damage in hypertensive disease has long been recognized. This chapter describes the structural and functional cardiac and vascular alterations noted with sustained, pathological increases in systemic arterial blood pressure, as well as the clinical relevance of these alterations. Through mechanisms that include the hemodynamic effects of increased cardiac afterload, direct cellular influences, and activation of and interactions with various neurohumoral systems, systemic hypertension is able to affect phenotypic changes to the heart that most commonly include concentric left ventricular hypertrophy, and which result in altered diastolic and systolic myocardial function. Although typically subclinical, the cardiovascular alterations noted in response to chronic, pathological increases in systemic arterial blood pressure may increase the affected animal’s risk for life-threatening complications, particularly in patients with pre-existing heart disease or in those faced with additional hemodynamic stressors.