Introduction
Heart failure (heart failure) and high blood pressure are mainly diseases affecting the elderly (>50 years). More than half of all people over 50 are affected. However, many people remain unaware of their illness for a long time, as blood pressure often rises slowly over the years, the heart failure develops slowly and the body is able to adapt well for the time being.
Symptoms often appear late or are not perceived as such by the person affected. Values above > 120/80 are referred to as high blood pressure. Heart failure can develop over time as a result of poorly adjusted blood pressure.
Causes of heart failure and blood pressure
The causes of heart failure are manifold. A distinction is made between functional disorders during systole, the phase in which the blood is ejected, and disorders of diastole, in which blood flows back into the heart. Coronary heart disease (CHD) or a heart attack can limit the pumping capacity of the heart muscle.
Only a small amount of blood can be expelled per heartbeat. Other causes are obstacles in the drainage path, e.g. heart valves that are too narrow (aortic valve stenosis) or excessive vascular resistance, as is the case with high blood pressure. Leaking heart valves allow blood to flow back into the heart during the heartbeat, so-called pendulum blood.
The heart is permanently weakened by the increased blood volume. With age, the elasticity of the heart muscle decreases, which means that less blood can flow into the heart during the diastole (filling phase) and thus less blood can be ejected. With age, the elasticity of the vessel walls decreases.
In addition, the diameter of the blood vessels decreases due to deposits. Both these factors lead to increased blood pressure. The heart must now pump against increased resistance.
In the long term, it cannot provide the normal pumping capacity, less blood is ejected into the circulation, and the stroke volume decreases. Reactively, the heart tries to compensate for the decrease by increasing the heart rate. This shortens the time in which the heart muscle itself is supplied with blood.
The heart muscle receives less nutrients and oxygen, which further reduces its performance. At the same time, more water is drawn back into the body via the kidneys (reabsorption) to compensate for the low beat volume. This in turn increases blood pressure.
This creates a vicious circle in which heart failure and high blood pressure negatively influence each other. In the case of a heart attack, a sudden closure of the coronary arteries leads to an acute undersupply of the heart muscle behind it. Myocardial cells are very susceptible to an oxygen deficiency and die quickly.
Depending on how long the blockage lasts and how large the affected vessel is, small or large parts of the heart muscle can die. The heart muscle is not capable of regeneration, resulting in functionless scars. As a result, the heart muscle can contract less during the ejection phase and stretch less during the filling phase. Both result in a decreasing pumping capacity.