Heart failure occurs when the heart cannot effectively pump or receive enough blood to meet the body's demands, leading to symptoms such as shortness of breath, reduced exercise capacity, fatigue, and edema. Hypertension is the primary and most common risk factor for heart failure, surpassing even smoking or metabolic disorders.

Prolonged hypertension forces the heart to overwork, causing structural and functional changes. Initially, the heart compensates by contracting more forcefully to pump blood into the arteries, leading to thickening of the heart muscle. Over time, the hypertrophied heart becomes fibrotic, less elastic, and struggles to relax. This gradually reduces its flexibility and pumping ability, resulting in heart failure.

Echocardiograms help detect the severity of heart failure for timely treatment. *Illustration: Tam Anh General Hospital*

Persistent high pressure also damages the heart walls, especially the left ventricle, making the heart stiffer. This reduces its ability to receive blood from the circulatory system, impacting blood flow to other organs. Chronic hypertension also accelerates atherosclerosis, narrowing or blocking coronary arteries and reducing blood supply to the heart muscle. This leads to oxygen and nutrient deprivation, increasing the risk of myocardial infarction. Uncontrolled hypertension progressively weakens the heart, diminishing its pumping capacity and ultimately leading to heart failure.

In its early stages, hypertension affecting the heart often develops silently, discovered incidentally during an echocardiogram or electrocardiogram. Some patients may experience mild shortness of breath, palpitations, or angina. As hypertension progresses and begins to cause heart failure, patients notice difficulty breathing, frequent night coughs, edema in their legs or ankles, unexplained weight gain, fatigue, and reduced exercise tolerance.

To prevent heart failure caused by hypertension, patients must take prescribed medications to control blood pressure, avoiding self-adjustments or discontinuation. Regular blood pressure monitoring and recording are essential for close tracking, allowing prompt reporting of abnormal readings to a doctor.

Everyone should adopt a healthy lifestyle, including a balanced diet (reducing dietary salt as directed by a doctor, prioritizing green vegetables, fresh fruits, whole grains, and fatty fish, and avoiding foods high in saturated fats). Regular exercise suitable for one's health, maintaining a healthy weight (18,5 < BMI < 23), avoiding smoking, and limiting alcohol are also crucial. Regular cardiovascular check-ups, along with blood lipid and blood sugar tests, help manage risk factors for heart failure.

Dr. Nguyen Thi Le Chi

Cardiology Unit

Tam Anh District 7 General Clinic