Fibrosis (scar tissue formation) is the determinant lesion in the subsequent evolution of the heart in a patient with high blood pressure. This item appeared in the latest edition of Nature Clinical Practice Cardiovascular Medicine, a journal that is part of the Nature group. The article published heart research recently carried out at the University of Navarra.
When arterial blood pressure rises, we have what is known as high blood pressure and the heart becomes overloaded, as it were: it pumps blood against the greater resistance created by this extra pressure. During most of the XX century doctors believed that the growth of cardiac muscle (left ventricular hypertrophy or LVH) presented by patients with high blood pressure was beneficial for the heart. It was thought that this change enabled the pumping of blood with greater force, compensating for the greater resistance due to higher blood pressure.
However, clinical and epidemiological studies at the end of the last century revealed that high blood pressure patients with LVH showed more frequent and more severe cardiac complications than high blood pressure individuals without LVH. This led a number of clinical and basic research groups to the hypothesis that not everything was quite right with the idea that hypertrophy of the cardiac muscle was the answer to high blood pressure. They also believed that, masked by the hypertrophy, they might find decisive alterations which, in the long term, might suggest a prognosis of high blood pressure cases with LVH worse than those without. It was now thought that the heart in high blood pressure cases may suffer structural changes thus producing massive scarring (myocardial fibrosis).
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