Heart failure in hypertensive patients

Abstract

In a series of 445 patients with high blood pressure and heart failure, a cause of failure in addition to hypertension was found in all but 12. Ischemic heart disease precipitated heart failure in half the patients and probably contributed to the development of failure in an additional 14 per cent. Other important causes of heart failure were: valvular heart disease, renal disease alone or combined with cardiac lesions, malignant hypertension, and respiratory infections. The other, less frequent causes of heart failure were combined to form a miscellaneous group. The presence of a renal lesion, as compared with no renal damage, almost doubled the mortality rate and reduced by 13 years the average age at death. Patients with renal disease had the highest blood pressures. The worsening prognosis of patients with hypertension and heart failure with increasing levels of blood pressure was shown to be due to the presence of a renal lesion rather than to the height of the blood pressure per se.