Analysis of the dual effects of blood pressure on cardiac function and stroke

What are the effects of hypertension on cardiac function?

The incidence of heart failure increases with age. The most common cause of heart failure is coronary artery disease, followed by hypertension. Hypertension causes left ventricular hypertrophy, myocardial matrix proliferation, and increased collagen synthesis, leading to ventricular remodeling, myocardial stiffness, diastolic dysfunction, and subsequently systolic dysfunction. Furthermore, hypertension promotes arteriosclerosis, resulting in myocardial ischemia and coronary artery disease. Hypertension is a common cause of heart failure.

Aggressive antihypertensive treatment can reverse left ventricular hypertrophy, reduce myocardial ischemia, and slow the onset of heart failure. When heart failure occurs, in addition to aggressive antihypertensive treatment, the following standard treatments should be actively implemented:

Diuresis is the foundation of heart failure treatment. Diuresis can reduce cardiac load and quickly relieve heart failure symptoms. Based on diuresis, the use of beta-blockers, ACE inhibitors, ARBs, and aldosterone receptor antagonists can significantly reduce the mortality rate of heart failure.

How does hypertension affect stroke?

Stroke is the most common complication of hypertension, and actively lowering blood pressure is the most effective measure for stroke prevention.

China has a high incidence of stroke. A 1997 WHO-MONICA study reported that the incidence of stroke in men aged 35-64 in Beijing was 247 per 100,000, and in women, it was 175 per 100,000. Studies of 10 population groups in my country showed a log-linear relationship between blood pressure levels and the risk of stroke: for every 10 mmHg increase in baseline systolic blood pressure, the relative risk of stroke increased by 49% (47% for ischemic stroke and 54% for hemorrhagic stroke); for every 5 mmHg increase in diastolic blood pressure, the risk of stroke increased by 46%.

Analysis of East Asian populations showed that the effect of elevated blood pressure on stroke incidence was 1.5 times stronger in Chinese and Japanese populations than in Western populations. Studies in my country suggest that the average systolic blood pressure level during baseline and long-term treatment in elderly patients with cerebrovascular disease is associated with stroke recurrence.

Active antihypertensive treatment is fundamental for preventing stroke recurrence in patients with hypertension. Achieving ideal blood pressure levels often requires combination therapy. Calcium channel blockers, diuretics, beta-blockers, ACE inhibitors, and ARBs can all be selected or used in combination.