Britannica Sources used in this answer

How can hypertension contribute to congestive heart failure?

Created from Britannica articles using AI. AI can make mistakes, so verify using Britannica articles.

The role of coronary artery disease in heart attack — cardiovascular disease This micrograph shows a cross section of a coronary artery narrowed by an atherosclerotic plaque (purplish matter inside the artery). Most heart attacks are caused by the rupture of an atherosclerotic plaque, which triggers the formation of a clot that abruptly blocks blood flow to part of the heart muscle.

Hypertension contributes to congestive heart failure primarily by forcing the heart to work against chronically elevated arterial pressure. This sustained workload often leads to the enlargement of the heart, a process that can eventually result in the failure of the heart to pump effectively.1

Specifically, the heart may respond to this chronic pressure by thickening its walls, known as ventricular hypertrophy, which increases the stiffness of the ventricle. This stiffness limits the heart's ability to fill properly, necessitating higher filling pressures that can lead to pulmonary congestion and the characteristic symptoms of heart failure, such as shortness of breath. Furthermore, hypertension increases the risk of coronary artery disease, which can further compromise the heart's blood supply and function. Additionally, complications from hypertensive disease, such as kidney failure, can cause abnormal fluid retention in the body, exacerbating the congestion associated with the condition.21