If you have hypertension (high blood pressure), your doctor may have talked to you about your risk of heart failure. But what exactly is heart failure, and how is it related to hypertension?

In this article, we’ll talk about hypertension and heart failure and how the two are related. We’ll learn about how hypertension is one of the biggest risks for heart diseases like heart failure. Finally, we’ll discuss how to reduce your risk of heart failure by managing your hypertension.

What Is Hypertension?

Hypertension means your blood pressure is higher than it should be. This is often called arterial hypertension because it affects the arteries, the blood vessels that carry blood from the heart to the rest of your body. Two numbers make up a blood pressure reading, usually written as a fraction, like 120/80. The first number is the systolic pressure, the blood pressure when your heart beats. The second number is diastolic pressure, or the blood pressure in between heartbeats. They are measured in millimeters of mercury (mm Hg).

Normal blood pressure is less than 120 (systolic) and less than 80 (diastolic) mm Hg. However, if your systolic pressure is greater than 130 mm Hg or your diastolic pressure is greater than 90 mm Hg, you have hypertension.

Almost half of adults living in the United States have hypertension. However, nearly one-third of people with hypertension don’t know they have it. Hypertension can be treated with a combination of medication and lifestyle changes. Uncontrolled hypertension puts you at risk of health issues like kidney disease or heart failure.

What Is Heart Failure?

Heart failure is a type of heart disease in which the heart isn’t working as well as it should. This means that the heart can’t pump enough blood to keep up with your body’s needs. Heart failure can develop suddenly due to an injury — like a heart attack — or over time due to long-term damage. Most cases of heart failure are caused by other medical conditions that can damage your heart. These include hypertension and coronary artery disease (narrowing or blockage of blood vessels in your heart). Symptoms of heart failure depend on the type and severity of your heart failure.

Can Hypertension Lead to Heart Disease and Heart Failure?

Uncontrolled hypertension puts you at a higher risk of developing heart disease. People with hypertension are three times as likely to develop heart disease as people with normal blood pressure. Your risk of cardiovascular disease due to hypertension also increases as you get older. Heart disease caused by long-term hypertension is called hypertensive heart disease. According to StatPearls, an online educational resource for medical professionals, the risk of heart failure due to hypertension is higher in women than in men.

How Does Hypertension Change the Heart?

Your heart is divided into four chambers, each with a specific job. Both sides of your heart have an atrium, which receives the blood, and a ventricle, which pumps the blood out of the heart. The right side of your heart receives blood from your body and then pumps it to your lungs to get reloaded with oxygen. The left side of your heart receives the oxygen-rich blood from the lungs and then pumps it to the rest of your body.

Hypertension changes the heart by making the left ventricle of the heart work harder to pump blood through the body. Over time, the extra work can cause a thickening of the walls of the left ventricle. This thickening is called left ventricular hypertrophy. If hypertension is left untreated, the walls of the heart can become stiff, making it even harder for the heart to pump blood. Eventually, the heart will not work well enough, leading to decreased blood flow and heart failure.

How Quickly Can Hypertension Change the Heart?

Changes to the heart from hypertension don’t happen immediately. Instead, they form over a long time in response to high blood pressure. On average, people have uncontrolled hypertension for 14 years before developing heart failure. This is why it’s important to control your blood pressure if you’re diagnosed with hypertension.

How Common Is Heart Failure in Hypertensive Heart Disease?

Hypertension is a major risk factor for heart failure. Studies from the journal Clinical Hypertension have shown that 90 percent of people with heart failure have already been diagnosed with hypertension. Also, hypertensive heart disease is responsible for about one-quarter of heart failure cases.

Hypertension puts you at risk of heart failure, but not everyone with hypertension will develop hypertensive heart disease and heart failure. It’s important to manage your hypertension to reduce your risk of complications.

Can Heart Failure Cause Hypertension?

Now that we’ve talked about how hypertension can lead to heart failure, you may be wondering if heart failure can cause hypertension. In short, heart failure can’t cause arterial hypertension. It is actually the opposite. If the heart is weak, it will tend to lower blood pressure because it can’t pump blood efficiently. Although heart failure can lower blood pressure due to weak pumping, people with heart failure can still have high blood pressure, but it’s not caused by the heart failure itself. Most people have what’s called primary hypertension, meaning we don’t know exactly what causes it. However, it’s also possible for heart failure to cause pulmonary hypertension, which is a specific type of hypertension.

Pulmonary hypertension refers to high blood pressure in the blood vessels connecting your lungs and your heart called pulmonary arteries. As heart failure progresses, the left side of the heart has a more difficult time pumping blood out of the heart to the rest of the body. This causes blood to back up in the vessels between your lungs and heart, leading to increased pressure in those vessels.

When blood backs up into your lungs, it’s called congestive heart failure and can result in pulmonary hypertension. Untreated pulmonary hypertension can lead to more heart problems, including right-sided heart failure. This happens because the right heart chambers pump blood into the pulmonary arteries, and high blood pressure makes it harder for them to pump efficiently. Consequences of right heart failure include leg swelling and liver failure.

How Can You Keep Your Condition From Getting Worse?

One of the best steps you can take if you’ve been diagnosed with hypertension is to keep your blood pressure under control. According to the Centers for Disease Control and Prevention (CDC), only about 1 in 4 people in the U.S. with hypertension have their blood pressure under control. However, lowering systolic blood pressure by just 10 mm Hg could reduce the risk of heart failure by 28 percent.

To help manage your hypertension and lower your risk of developing heart failure, it’s important to follow your treatment plan. Your doctor may prescribe medications to lower your blood pressure. There are many types of medicine used to treat hypertension. These include diuretics (water pills), calcium channel blockers, ACE inhibitors, and angiotensin 2 receptor blockers. Your doctor will recommend the type that’s best for you.

In addition to medications, your health care provider may suggest lifestyle changes. They may recommend that you eat a heart-healthy diet, get regular exercise, or work toward reaching a healthier weight. Finally, the American Heart Association recommends regular blood pressure readings. This helps make sure that your treatment plan is working well.

You’ll need to regularly follow up with your doctor to manage your hypertension. At your cardiology visits, your doctor may also look at other measures of heart health, like heart rate and heart rhythm. If you have more questions about hypertension and your risk of heart failure, be sure to speak with your health care provider.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 61,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Have you been diagnosed with hypertension or heart failure? Do you have more questions about how the two conditions are related? Share your experiences in the comments below, or start a conversation by posting on your Activities page.