The transition from compensatory phase of left ventricular hypertrophy (LVH) to decompensatory phase remains enigmatic and still eludes an answer. The adaptive remodeling in course of time advances to maladaptive remodeling, pushing the heart to a decompensated stage. The progression of hypertrophy during hypertension occurs initially as a compensatory mechanism to maintain the cardiac output due to increased wall stress. Depending upon the duration and nature of the stimulus, hypertensive heart disease (HHD) can either lead to concentric or eccentric hypertrophy with either a preserved or a reduced left ventricular (LV) ejection fraction (LVEF) ultimately resulting in malfunctioning of the heart. The cardiac changes during aging go unnoticed until they require medical attention. Uncontrolled/unattended hypertension leads to myocardial hypertrophy, subsequently progressing to cardiac failure 1. High blood pressure and aging are two independent and critical risk factors for CVDs. World Health Organization (WHO) reports that an estimated 1.13 billion people worldwide have hypertension, and between 20, the proportion of the world’s population over 60 years will nearly double from 12% to 22%. This review highlights the molecular mechanisms of cardiac structural and functional alterations associated with hypertension and aging.Ĭardiovascular diseases (CVDs), affecting the heart and circulation, are the leading cause of mortality and morbidity. The pace at which these pathophysiological changes occur varies between individuals owing to many genetic and environmental risk factors. However, these structural changes in the cardiovascular system lead to alterations in overall cardiac physiology and function. In contrast, the cardiac changes that occur with aging are a slow but life-long process and involve all of the structural components in the heart and vasculature. The pathological changes occurring during hypertensive heart disease are very complex and involve many cellular and molecular alterations. Left ventricular hypertrophy consequent to pressure overload is recognized as the most important predictor of congestive HF and sudden death. Hypertension, or elevated blood pressure, if left untreated can result in myocardial hypertrophy leading to heart failure (HF). Hypertension and aging are two major risk factors for the development of cardiac structural and functional abnormalities. Cardiovascular diseases are the leading cause of mortality and morbidity worldwide and account for more than 17.9 million deaths (World Health Organization report).
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