Chronic hypertension echocardiography

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Chronic Hypertension Microchapters


2017 ACC/AHA Hypertension Guidelines

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Differentiating Hypertension from other Diseases

Epidemiology and Demographics

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Natural History, Complications and Prognosis


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Hypertension is associated with a a multitude of cardiac diseases, such as left ventricular hypertrophy (LVH), myocardial infarction (MI), angina pectoris, systolic or diastolic heart failure, and sudden death. Collectively, they are referred to as "hypertensive heart disease". On 2D echocardiography, signs of LVH and heart failure can be assessed and quantified over time in hypertensive patients.


According to the American Society of Echocardiography[1], LVH is defined as LV mass index > 95 g/m2 in women and 115 g/m2 in men using 2D echocardiography. The following findings in echocardiography are helpful for the diagnosis of LV dysfunction.[2]

Left Ventricular Systolic Dysfunction

  • LV ejection fraction (LVEF) < 50%

Left Ventricular Diastolic Dysfunction

Often categorized according to tissue Doppler findings as: mild, moderate, or severe.

  • E/E’ > 15: Ratio of early mitral valve flow (E) to early diastolic lengthening (E’) velocities
  • E/A < 0.5: Ratio of peak early (E) to peak late (A) Doppler mitral valve flow velocity
  • Deceleration time of early Doppler mitral valve flow > 280 ms
  • LA volume indexed to body surface area > 40 mL/m2
  • LV mass inde > 122 g/m2 for women and > 149 g/m2 for men

2013 ESH/ESC Guidelines For The Management of Arterial Hypertension (DO NOT EDIT)[3]

Summary of Recommendations on The Search for Asymptomatic Cardiovascular Disease (DO NOT EDIT)[3]

Class IIa
"1. An echocardiogram should be considered to refine CV risk, and confirm ECG diagnosis of LVH, left atrial dilatation or suspected concomitant heart disease, when these are suspected. (Level of Evidence: B)"


  1. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA; et al. (2005). "Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology". J Am Soc Echocardiogr. 18 (12): 1440–63. doi:10.1016/j.echo.2005.10.005. PMID 16376782.
  2. Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE; et al. (2007). "How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology". Eur Heart J. 28 (20): 2539–50. doi:10.1093/eurheartj/ehm037. PMID 17428822.
  3. 3.0 3.1 Authors/Task Force Members. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A; et al. (2013). "2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)". Eur Heart J. 34 (28): 2159–219. doi:10.1093/eurheartj/eht151. PMID 23771844.

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