Pregnancy-induced hypertension and its effects on the heart and prevention and treatment measures

Gestational hypertension: Gestational hypertension syndrome is a type of secondary hypertension, also known as preeclampsia-eclampsia. It usually develops after 20 weeks of gestation, characterized by rapid weight gain (more than 0.5 kg per week), lower limb and abdominal wall edema, and in severe cases, ascites, gradually progressing to hypertension.

The clinical diagnostic criteria are blood pressure exceeding 130/90 mmHg after 20 weeks of gestation, or an increase in blood pressure exceeding 30/15 mmHg compared to previous levels, accompanied by proteinuria and edema. In the most severe stage of gestational hypertension, eclampsia can occur, with symptoms such as fixed gaze, dilated pupils, tremors of the corners of the mouth and muscles, and even muscle rigidity, potentially leading to coma.

The effects of hypertension on the heart: The heart is a vital organ for maintaining blood pressure, and long-term high blood pressure can damage the heart, causing changes in its structure and function. Early damage to the heart from hypertension primarily causes cardiac hypertrophy, while later damage leads to arrhythmias and heart failure. Hypertension often co-occurs with coronary atherosclerosis, and hypertensive patients are twice as likely to develop coronary heart disease as those with normal blood pressure.

Numerous epidemiological studies have found that hypertension is one of the most common causes of left ventricular hypertrophy (LVH). Early LVH often presents with no obvious symptoms and is diagnosed primarily based on examinations such as electrocardiogram (ECG), echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI), with echocardiography currently being the most commonly used diagnostic method.

Hypertension is the most important risk factor for coronary heart disease. It accelerates the formation and development of coronary artery sclerosis, increases the weight of the heart, and disrupts the balance between myocardial oxygen supply and demand, leading to angina and even myocardial infarction. The main causes of death from hypertensive heart disease are myocardial infarction and heart failure.

Hypertension is one of the most common causes of heart failure. Hypertensive patients often present with left ventricular hypertrophy, diastolic dysfunction, and elevated pulmonary venous pressure before the onset of heart failure symptoms. Clinically, they exhibit symptoms of pulmonary congestion, such as frequent shortness of breath, varying degrees of dyspnea, rales in the lungs, increased heart rate and pathological third or fourth heart sounds on cardiac auscultation, pulmonary congestion visible on X-ray, and elevated left ventricular end-diastolic pressure detected by cardiac catheterization.

Heart failure caused by hypertension is primarily left ventricular failure, but can also be biventricular failure. Left ventricular failure is mainly characterized by decreased cardiac output and pulmonary congestion, clinically presenting as dyspnea and reduced activity levels. As the condition progresses, exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and severe cerebral hypoxia may occur. In severe cases, it can manifest as acute pulmonary edema, with symptoms such as severe dyspnea, rapid breathing, inability to lie flat, profuse sweating, restlessness, coughing up pink frothy sputum, and cyanosis. If not treated promptly, the mortality rate is high.