Diastolic Dysfunction as a Link Between Hypertension and Heart Failure

Hypertension significantly contributes to cardiovascular morbidity and mortality by causing substantial structural and functional adaptations, including left ventricular diastolic dysfunction. Left ventricular diastolic dysfunction is characterized by abnormalities in left ventricular filling, including decreased diastolic distensibility and impaired relaxation, and it may represent an early measure of myocardial end-organ damage. Diastolic dysfunction may well precede development of left ventricular hypertrophy in hypertension and possibly is characteristic of an important pathophysiologic link between hypertension and heart failure with preserved ejection fraction. No specific therapeutic regimen has shown to benefit patients who have heart failure with preserved ejection fraction, and thus there is a need to understand the potential mechanisms primarily responsible for this clinical syndrome and its relationship to hypertension and diastolic dysfunction.