From hypertension to heart failure

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Arterial hypertension, coronary heart disease, and heart failure are prevalent cardiovascular conditions that are closely interrelated, significantly impacting prognosis. Epidemiological studies highlight hypertension as a major risk factor for developing heart failure, with only 25% of patients receiving adequate management and 50% of cases remaining unrecognized or untreated. Patients with existing hypertension who experience an acute myocardial infarction often lack typical angina symptoms, resulting in larger infarct territories and a higher incidence of life-threatening arrhythmias, leading to worse in-hospital mortality and long-term outcomes. Elevated blood pressure post-infarction doubles the risk of heart failure. Given the interconnectedness of these conditions, selecting an appropriate therapeutic strategy is crucial. First-line agents with prognostic value across all three conditions should be prioritized, as their combined effects may yield additional benefits. Such therapeutic decision-making can also help prevent complications that may not yet be clinically evident, such as heart failure.