Cor Vasa 2013, 55(3):e259-e263 | DOI: 10.1016/j.crvasa.2013.04.002

Arterial hypertension and chronic heart failure

Filip Málek
Ambulance srdečního selhání a hypertenze, Kardiovaskulární centrum, Nemocnice Na Homolce, Praha, Česká republika

Arteriální hypertenze samotná nebo v kombinaci s ischemickou chorobou srdeční předchází rozvoji srdečního selhání. Framinghamská studie ukázala, že hypertenze je hlavním rizikovým faktorem rozvoje srdečního selhání. Arteriální hypertenze však není jediným faktorem, který k rozvoji srdečního selhání přispívá. Syndrom srdečního selhání vzniká jako následek řady systémových odpovědí organismu a rozvoj srdečního selhání je komplex progresivních procesů spojených s kardiovaskulárními onemocněními, která vznikají následkem rizikových faktorů: hypertenze, obezity, kouření, dyslipidemie a diabetes mellitus. Arteriální hypertenze je hlavním prekursorem hypertrofie levé komory srdeční. Zpočátku vede proces srdeční hypertrofie k diastolické srdeční dysfunkci. Systolická dysfunkce se u jedinců v počátečním stadiu hypertenze objevuje zřídka. Srdeční hypertrofie je významným rizikovým faktorem infarktu myokardu a komorových arytmií. Asymptomatická systolická a diastolická srdeční dysfunkce může vést k rozvoji manifestního srdečního selhání.
Primární prevence srdečního selhání by měla být založena na těsné a soustavné kontrole krevního tlaku. Tato léčba by měla zahrnovat léky inhibující systém renin-angiotensin-aldosteron. Při léčbě arteriální hypertenze u pacientů s již rozvinutým srdečním selháním musíme brát v potaz převažující typ poruchy srdeční funkce - diastolické nebo systolické.

Keywords: Arteriální hypertenze; Diastolická dysfunkce; Epidemiologie; Farmakoterapie; Hypertrofie levé komory; Srdeční selhání; Systém renin-angiotensin-aldosteron; Systolická dysfunkce

Received: February 25, 2013; Accepted: April 4, 2013; Published: June 1, 2013  Show citation

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Málek F. Arterial hypertension and chronic heart failure. Cor Vasa. 2013;55(3):e259-263. doi: 10.1016/j.crvasa.2013.04.002.
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