Hypertensive Heart Disease: SAQ Solutions

Below are the solutions to the self-assessment questions for Hypertensive Heart Disease.

1. Chronic high blood pressure (hypertension)
   Higher blood pressures require that the heart muscle be able to pump out blood more forcefully to maintain a pressure gradient to get blood to extremities. In order for the heart and circulatory system to accommodate this change in function, physiological changes occur. These changes constitute the disease.
2. Coronary arteries become more narrow, and the heart becomes enlarged.
   Heart enlargement occurs to accommodate the higher blood pressure against which it must pump. This heart enlargement itself not only constricts the coronary arteries, but plaque buildup that causes the initial hypertensive forces to which the heart must react also causes coronary artery narrowing.
3. The left ventricle needs to pump blood throughout the body rather than just to the lungs. A higher resistance to flow requires a stronger pump force.
   The systemic circulation has many more vessels and organs that must be supplied with blood in comparison to the pulmonary circulation. Because the left ventricle pumps oxygenated blood to the entire systemic circulation, it will need to accomodate more through hypertrophy to a higher blood pressure.
4. C. Exercise leads to HHD since the heart undergoes the same compensatory mechanisms for the increased pump force loads
   During exercise, one’s body needs more oxygen and metabolic waste removal, thus requiring more blood flow throughout the body. This would require a more muscular heart, also leading to hypertrophy.