Time to reconsider the perception and management of hypertensive heart disease

Abstract

Heart failure (HF) is a global pandemic. Its prevalence is increas-ing with the aging of the population, with improved treatmentof ischemic heart disease (IHD) and the availability of effectiveevidence-based therapies that prolong survival of patients with HF.Despite the age-standardized stable worldwide prevalence of sys-temic arterial hypertension, but considering that the rates of hyper-tension control with treatment have worsened in recent years,hypertension remains one of the main causes of HF with a globalimpact. In the last two decades, the presence of hypertension hasincreased in incident cases of HF either with reduced (HFrEF) orwith preserved ejection fraction (HFpEF).1Additionally, the lifetimerisk of HF is higher in people with hypertension than in those withnormal blood pressure (BP), especially in women and the elderly.1On the other hand, the incidence of de novo HF in 23 hyperten-sion trials involving193 424 patients was 28.9% (n=7171)oftheall major cardiovascular events reported.2Therefore, HF continuesto represent a major concern in hypertension management.