Cardiac Phenotypes in Secondary Hypertension

Highlights

• Secondary forms of hypertension, when untreated, cause more cardiac damage than primary hypertension and are associated with greater CV risk.

• Cardiac damage includes not only myocardial hypertrophy but also inflammation, fibrosis, apoptosis, and necrosis.

• Specific and timely treatment of secondary hypertension is needed to prevent cardiac damage.

Abstract

Several forms of secondary hypertension carry a high risk of cardiac morbidity and mortality. Evaluation of cardiac phenotypes in secondary hypertension provides a unique opportunity to study underlying hormonal and biochemical mechanisms affecting the heart. We review the characteristics of cardiac dysfunction in different forms of secondary hypertension and clarify the mechanisms behind the higher prevalence of heart damage in these patients than in those with primary hypertension. Attention to the specific clinical/biochemical phenotypes of these conditions may assist clinicians to screen for and confirm secondary forms of hypertension. Thereby, early signs of heart damage can be recognized and monitored, allowing individualized treatment to delay or prevent evolution toward more advanced disease.