Chronic heart failure in hypertensive patients

Abstract

Introduction: Hypertension remains a major public health problem associated with considerable morbidity and mortality. Hypertensive heart disease is a constellation of abnormalities that includes left ventricular hypertrophy (LVH), systolic and diastolic dysfunction and their clinical manifestations including arrhythmias and symptomatic heart failure (HF). Presently, diastolic heart failure accounts for about 50% of the heart failure population. Purpose and objectives: To determine the clinical and laboratory characteristics of heart failure in patients with hypertension. Methods: It was a prospective study of 23 patients admitted in Institute of Cardiology diagnosed with grade I-III systemic hypertension. We evaluated general date, history of disease, physical examination, laboratory and instrumental results, including ECG and echocardiography. Results: In the study group was observed the prevalence of women, the rate women: man being 1.9:1, with mean age 59.3 ± 0.02. General data indicated that most patients originate from urban areas - 19 (82.60%) versus 4(17.40%) from the village. Family history of hypertension was present in 2 (9%) patients. Among the cardiovascular risk factors were identified type II diabetes in 5(21.7%) and obesity in 5(21%) patients. The distribution according stages of hypertension demonstrated that most patients had stage 1 1 -1 8 (78.2%), followed by 5 (21.8%) patients - stage III and only one patient had stage I of hypertension. Clinical spectrum of complains showed fatigue in 11, dyspnea - 16, reduced exercise tolerance and peripheral edema - 6 patients from study group. By NYHA classification predominated the III funcţional class - 14(60, 86%), followed by II class - 6 (26%) and only 3 (13, 04%) patients had I NYHA class. ACC/AHA stages of HF indicated that most of patients were included in stage C - 20 patients, 2 patients - stage A and only 1 patient had sage B ofH F. Analyzing ECG was established left ventricular hypertrophy in 14 (56.6%). By echocardiography were appreciated concentric hypertrophy in 16 (69.6%), cardiomegaly was determined by dilatation of left atrium in 19 (82.6%) patients, left ventricle - 3(13.04%) and decreased EF <50% in only 4(17.39%) cases. Conclusion: Patients with hypertension and clinical diagnosis of heart failure presented left ventricular hypertrophy and impaired diastolic filling without systolic dysfunction.