Mavrogeni S, Katsi V, Vartela V et al. The Emerging Role of Cardiovascular Magnetic Resonance in the Evaluation of Hypertensive Heart Disease. BMC Cardiovasc Disord. 2017;17(1):132. doi:10.1186/s12872-017-0556-8 - Pubmed The first definition of HHD was proposed in 1979 by the New York Heart Association. Hypertensive heart disease was defined as an anatomofunctional alteration characterized by left ventricular hypertrophy (LVH) and cardiac failure in patients with systemic hypertension19. With this definition, HHD was made equivalent to heart failure. Lyve: Periferie-naar-cloudplatform voor massaopslag Lyve Cloud: Voordelige objectopslag, ontworpen voor de multicloud Consequently, a comprehensive definition of hypertensive heart disease should include the most important alterations documented in these three territories.

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Male patient. 57 years-old. Risk factors: heavy smoker, type 2 diabetes, and hypertension. Acute inferior myocardial infarction. Echocardiogram shows left ventricular hypertrophy, inferior akinesis, and EF= 56%. Kuruvilla S, Janardhanan R, Antkowiak P et al. Increased Extracellular Volume and Altered Mechanics Are Associated With LVH In Hypertensive Heart Disease, Not Hypertension Alone. JACC Cardiovasc Imaging. 2015;8(2):172-80. doi:10.1016/j.jcmg.2014.09.020 - Pubmed If hemodialysis patients currently treating three days per week are experiencing large fluid gains, impaired cardiovascular function, hemodynamic instability, or are otherwise not tolerating their current therapy, they may want to consider more frequent hemodialysis. More frequent home hemodialysis is associated with: Significant Cardiovascular Benefits: Angiotensin-converting enzyme (ACE) inhibitors, AT 1 receptor antagonists and diuretics showed good results in the treatment with regression of left ventricular hypertrophy, myocardial fibrosis and an improvement in diastolic dysfunction 3,4,9,10. Concomitant ischemic heart disease, heart failure and atrial fibrillation or arrhythmias should be treated accordingly. Verdecchia P, Angeli F, Gattobigio R, Sardone M, Porcellati C. Asymptomatic left ventricular systolic dysfunction in essential hypertension: prevalence, determinants, and prognostic value. Hypertension 2005;45:412-8.Ischaemia in hypertensive patients is frequently caused by microvascular dysfunction; if atherosclerosis develops, epicardial coronary disease and, finally, acute coronary syndromes can be present as well. Home nocturnal hemodialysis is performed overnight while the patient and care partner are sleeping. It is a slower and longer treatment that more closely resembles healthy kidney function, which may be gentler on the heart compared to standard three-times weekly dialysis. 20 You must ensure that you have a clean and safe environment for your treatments. You also need to set aside space in your home for the needed supplies. In terms of left ventricle involvement, the categories selected have been the three main stages of the former concept of "hypertensive heart disease": response of ventricular myocardium begins with left ventricular hypertrophy (recognised either by electrocardiography or echocardiography); afterwards, diastolic dysfunction may appear, sometimes evolving to systolic dysfunction, despite that symptoms of heart failure may be similar. Finkelstein FO, Schiller B, Daoui R, et al. At-home short daily hemodialysis improves the long-term health-related quality of life. Kidney Int. 2012;82(5):561-569.

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Authors (year): WHO/ISH (1993), Framingham Study (1987),Fröhlich(1989), Ganau et al (1992), Iriarte et al (1993)

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Ayus JC, Achinger SG, Mizani MR, et al. Phosphorus balance and mineral metabolism with 3 h daily hemodialysis. Kidney Int. 2007;71(4):336-342.