What Is Hypertensive Heart Disease? Everything to Know

Medically Reviewed By Angela Ryan Lee, MD, FACC
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Hypertensive heart disease refers to structural changes in the heart and coronary arteries resulting from chronic high blood pressure.  Hypertension, also known as high blood pressure, affects around half of all adults in the United States. Managing high blood pressure greatly reduces the risk of hypertensive heart disease, which is a condition that can lead to severe medical complications such as heart failure.

This article looks at the symptoms and causes of hypertensive heart disease. It also discusses treatments, when to contact a doctor, and steps you can take to decrease your risk.

What are the symptoms of hypertensive heart disease?

There is a red balloon in the shape of a heart.
Giada Canu/Stocksy United

Most people with high blood pressure do not have symptoms until the condition progresses and serious complications arise. 

Complications such as heart failure and cardiac arrest may include symptoms such as:

These symptoms appear when the condition progresses. To avoid these complications, it is best to have regular checkups with your doctor so they can assess your blood pressure and other vital signs.

Learn more about high blood pressure.

What causes hypertensive heart disease?

Chronic high blood pressure causes hypertensive heart disease. Over time, constant elevated pressure on the heart muscle causes these structures to weaken and enlarge. This is called hypertrophy.

Hypertrophy causes the heart to not pump as well, leading to decreased blood flow around the body.

The most common causes of hypertension include:

  • lack of physical activity
  • smoking
  • obesity
  • genetic predisposition
  • consuming a diet high in sodium and low in potassium
  • drinking too much alcohol
  • not getting enough sleep
  • certain medical conditions such as diabetes or kidney disease

Learn more about what can cause hypertension.

Current American Heart Association guidelines define hypertension as follows:

Systolic (upper number)Diastolic (lower number)
Elevated blood pressure120–129 mm Hgandless than 80 mm Hg
Hypertension stage 1130–139 mm Hgor80–89 mm Hg
Hypertension stage 2140 mm Hg or higheror90 mm Hg or higher
Hypertension stage 3 (hypertensive crisis)higher than 180 mm Hgand/orhigher than 120 mm Hg

Learn about blood pressure readings.

What are the treatments for hypertensive heart disease?

The most effective way to manage hypertensive heart disease is to keep blood pressure under control. 

Treatment options available include lifestyle changes such as:

  • reducing salt intake
  • following the DASH diet
  • reducing alcohol intake or drinking in moderation
  • maintaining a moderate weight
  • getting regular physical activity
  • managing stress levels
  • getting adequate sleep

Learn more about ways to lower your blood pressure.

Your doctor may also prescribe medication to help manage your blood pressure. These may include:

  • diuretics
  • angiotensin-converting enzyme (ACE) inhibitors
  • calcium channel blockers
  • vasodilators
  • beta-blockers

Learn more about medications doctors prescribe for high blood pressure.

In some cases, a strong commitment to understanding your condition and following the treatment plan can reduce risks associated with hypertensive heart disease.

When should I see a doctor?

Even without any recognizable symptoms, doctors recommend getting your blood pressure checked at least once a year. This helps detect early signs of hypertensive heart disease before it progresses and creates more serious complications.

If you have any persistent symptoms that might be related to this medical condition, it is important to seek medical attention immediately.

Symptoms can include, but are not limited to:

If your blood pressure readings are consistently higher than 130/80 millimeters of mercury (mm Hg) as taken by your home monitoring device, contact your doctor. Additionally, if you have been experiencing persistent headaches or vision problems, make sure to make an appointment with your doctor right away. 

The earlier your doctor diagnoses and treats the condition, the better the outcome for your overall health.

Find out more about when to contact a doctor for hypertension.

How do doctors diagnose hypertensive heart disease?

Health professionals may use several tests to diagnose hypertensive heart disease. These can include:

  • EKG, which checks for enlargement of the heart ventricles and problems with the electrical conduction inside the heart
  • lab tests, such as a basic metabolic panel (BMP), lipid panel, complete blood count (CBC), and thyroid stimulating hormone (TSH) test
  • urinalysis to check for protein in the urine

An echocardiogram, which is an ultrasound of the heart, is not a routine test for this condition. However, it may help evaluate people with symptoms of heart failure or those under 18 years who are experiencing chronic high blood pressure.

What are the risk factors for hypertensive heart disease?

Risk factors for hypertensive heart disease include risk factors for hypertension. A combination of risk factors exists for high blood pressure, including those a person is born with and their lifestyle choices.

Hereditary and physical risk factors include:

  • family history of hypertensive heart disease
  • being an older adult
  • being of African American heritage
    • One reason for this may be inequities in healthcare.
  • having chronic kidney disease
  • having sleep apnea
  • having diabetes

Lifestyle and modifiable risk factors include:

  • consuming an unbalanced diet high in sodium, calories, and sugar
  • lack of physical activity
  • being overweight or having obesity
  • regularly consuming too much alcohol
  • having high cholesterol
  • smoking and other tobacco use
  • chronic high levels of stress

It is important to recognize these potential triggers to minimize your chances of experiencing this condition. 

Can I prevent hypertensive heart disease?

Consuming a balanced diet, exercising regularly, and maintaining a moderate weight are several steps you can take to lower your risk of hypertensive heart disease.

Other steps you can take include avoiding tobacco use and monitoring your blood pressure at home. 

Additionally, if you have any underlying conditions that may contribute to your risk of hypertensive heart disease, speak with your doctor about how to manage them. 

By taking these precautions and working with your medical team, you can make strides toward bettering your cardiovascular health while helping to prevent hypertensive heart disease.


Hypertensive heart disease is a condition that may occur when a person has chronic high blood pressure. The condition involves damage to the heart and blood vessels, which may cause other serious medical conditions.

Typically, there are no symptoms until the condition progresses and causes complications such as heart failure or heart attack. Then a person may experience chest pain, shortness of breath, and other symptoms. 

Treatment involves managing blood pressure and preventing future complications. 

See your medical professional right away if you believe you are at risk for hypertensive heart disease. They can run several tests to check your blood pressure and the health of your heart.

You can reduce your risk of hypertensive heart disease by controlling your blood pressure with lifestyle changes and medication if necessary.

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Medical Reviewer: Angela Ryan Lee, MD, FACC
Last Review Date: 2023 Jan 27
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