Cardiac effects

Increased systemic blood pressure, which increases afterload on the heart, also increases myocardial workload. This can have both acute and chronic adverse effects. Afterload is a major determinant of myocardial oxygen demand; thus sudden increases can induce or aggravate myocardial ischemia and worsen underlying heart failure. The acute onset of pulmonary edema or myocardial ischemia is a common presentation of a hypertensive emergency.

Longstanding increased afterload, even if not severe, eventually produces a failing heart. Although the mechanisms are not entirely clear, this has been shown in both clinical practice and animal models. Increased afterload can also cause isolated diastolic dysfunction. This results in a relatively stiff ventricle with increases in end-diastolic pressure and decreases in end-diastolic filling volume. The ventricle is then less tolerant of increased preload volumes and is prone to failure.

Sleep Apnea

Sleep Apnea

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