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If left untreated hypertensive heart disease can lead to the following potentially life-threatening conditions: The main cause of hypertensive heart disease is elevated peripheral vascular resistance and arterial hypertension. Radiographic features Over 1.1 billion people worldwide, one-fourth of all men and one-fifth of all women suffer from hypertension and the condition is in control in less than 20% of the affected population. It is also the main risk factor and cause of hypertensive heart disease 1. Associations

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Lyve: Periferie-naar-cloudplatform voor massaopslag Lyve Cloud: Voordelige objectopslag, ontworpen voor de multicloud Consequently, a comprehensive definition of hypertensive heart disease should include the most important alterations documented in these three territories. Performing more frequent hemodialysis treatments at home may improve your patients’ quality of life in addition to providing clinical benefits. Hall YN, Larive B, Painter P, et al. Effects of six versus three times per week hemodialysis on physical performance, health, and functioning: Frequent Hemodialysis Network (FHN) randomized trials. Clin J Am Soc Nephrol. 2012;7(5):782-794.Pinciaroli AR. Restuls of daily hemodialysis in Catanzaro: 12-year experience with 22 patients treated for more than one year. Hemodial Int. 1998;2(1):12-17. Spanner E, Suri R, Heidenheim AP, Lindsay RM. The impact of quotidian hemodialysis on nutrition. Am J Kidney Dis. 2003;42(1 suppl):30-35. Díez J, Querejeta R, López B, González A, Larman M, Martínez Ubago J. Losartan-Dependent Regression of Myocardial Fibrosis Is Associated With Reduction of Left Ventricular Chamber Stiffness in Hypertensive Patients. Circulation. 2002;105(21):2512-7. doi:10.1161/01.cir.0000017264.66561.3d - Pubmed Dialysis is a journey and can involve multiple modalities. Regular communication and education about appropriate treatment options is important. Proactively in working with patients and educating them on potential future modalities, including more frequent HHD, may help ensure successful transitions and improved outcomes. We propose the term hypertensive cardiopathy or hypertensive heart disease to be used to describe a complex and variable syndrome that usually, but not necessarily, includes clinical manifestations derived from: left ventricular hypertrophy and dysfunction, be it diastolic or systolic; myocardial ischemia; and rhythm abnormalities, all of them caused by the effects on the heart of chronically elevated blood pressure. Table 2 depicts the proposed comprehensive classification including those three possibilities of cardiac kinvolvement (Ventricle, Ischemia and Arrhythmia); so, the acronym VIA is proposed as well.

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Mensah GA, Croft JB, Giles WH. The heart, kidney, and brain as target organs in hypertension. Cardiol Clin 2002;20:225-47. Varela-Roman A, Grigorian L, Barge E, Bassante P, de la Peña MG, Gonzalez-Juanatey JR. Heart failure in patients with preserved and deteriorated left ventricular ejection fraction. Heart 2005;91:489-94. Kuruvilla S, Janardhanan R, Antkowiak P et al. Increased Extracellular Volume and Altered Mechanics Are Associated With LVH In Hypertensive Heart Disease, Not Hypertension Alone. JACC Cardiovasc Imaging. 2015;8(2):172-80. doi:10.1016/j.jcmg.2014.09.020 - Pubmed

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Hypertensive heart disease encompasses various structural and functional changes of the heart, in particular, the cardiac wall on a microscopic and macroscopic level including the development of myocardial fibrosis and cardiac chamber remodeling as ventricular hypertrophy, atrial enlargement as well as aortic root dilatation and alterations of the coronary circulation 2,3.

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ESRD has a significant impact on patients’ entire lives, not just their physical health. That is why it is important to consider a patient’s individual lifestyle needs when discussing home hemodialysis as a potential therapy option, including:Jaber BL, Lee Y, Collins AJ, et al. Effect of daily hemodialysis on depressive symptoms and postdialysis recovery time: interim report from the FREEDOM (Following Rehabilitation, Economics and Everyday-Dialysis Outcome Measurements) Study. Am J Kidney Dis. 2010;56(3):531-539. Despite a number of studies performed over the years, no comprehensive definition and no clinically meaningful classification of hypertensive heart disease (HHD) is available. That is why the Steering Committee of the Hypertension Working Group of the Spanish Society of Cardiology developed a clinical classification of the so called “hypertensive cardiopathy” based on the three main heart components involved in patients with chronic elevated blood pressure8. This classification is briefly reviewed next. 3- The basis for a clinical classification of hypertensive heart disease AH: Arterial hypertension; EF: left ventricular ejection fraction; FC: functional capacity; LV: left ventricle; LVH: left ventricular hypertrophy Verdecchia P, Angeli F, Gattobigio R, Sardone M, Porcellati C. Asymptomatic left ventricular systolic dysfunction in essential hypertension: prevalence, determinants, and prognostic value. Hypertension 2005;45:412-8. The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. Boston: Little, Brown, and Co,1979:12.