Blood Pressure and Heart Failure

Heart failure is a serious health condition where the heart is unable to pump blood around the body properly, often because its muscles have become too weak or stiff. This short article will outline what heart failure is, what receiving a diagnosis means, and how it can be related to your blood pressure.

What is heart failure?

Heart failure is a general term for when your heart is no longer strong enough to properly pump blood around the body. This condition may be “acute” when it occurs quickly (potentially leading to unplanned hospitalisation), or “chronic”, developing over time.

Various factors lead to heart failure:

• When blood pressure is persistently raised, arteries may begin to stiffen and harden. When they narrow, the heart finds it more difficult to push blood around the body, meaning it has to work harder against increased resistance. 
• Coronary artery disease may impair blood flow to the heart muscle itself, reducing the availability of nutrients and oxygen that enable muscle growth and repair. 
• All this extra work will start damaging the heart and change its muscular structure. It can become enlarged (hypertrophy), especially in certain areas such as the left ventricle. This will lead to a thicker muscle which will become more rigid as time goes by. 
• These changes mean that, while your heart can still pump blood, it will have a harder time doing so, becoming less and less efficient at bringing oxygen and nutrients to the body. This can, in turn, lead to a cascade of adverse health consequences. 

What causes it?

Patients with heart failure often have hypertension at the same time. This is because having high blood pressure can increase how hard your heart has to work to properly pump blood around the body. There are also several other causes, including:

• Coronary heart disease, a condition where the arteries that supply blood to the heart become clogged up with fatty substances (atherosclerosis), which may cause angina or a heart attack
• Conditions affecting the heart muscle (collectively called cardiomyopathy)
• Heart rhythm problems (arrhythmias), such as atrial fibrillation
• Damage or other problems with the heart valves
• Congenital heart disease, or birth defects that affect the normal workings of the heart

There are many other risk factors including: obesity, anaemia, excess alcohol intake, an overactive thyroid or high pressure in the lungs (pulmonary hypertension).

Are there any symptoms?

Symptoms of heart failure can include breathlessness after activity or even at rest, feeling tired most of the time and finding exercise exhausting, as well as swollen ankles and legs. Other symptoms can include a persistent cough, a fast heart rate and dizziness.

If you experience any of these conditions, it’s a good idea to speak with a doctor or medical professional.

How is it treated?

Treatment usually involves managing symptoms, slowing disease progression where possible and improving overall quality of life. Common management options include:

• Making changes to your lifestyle, for example cutting back on dietary salt, alcohol, caffeine, and getting more exercise.
• Medicines, potentially to help with symptoms, lower blood pressure, reduce fluid build up and improve heart function.
• Implantation of a medical device to control the heart’s rhythm, colloquially referred to as a pacemaker.
• Surgery, such as a heart bypass or heart transplant.

What’s the link with blood pressure?

As well as hypertension causing stiffening and thickening of the arteries, it’s also associated with atrial fibrillation and ventricular arrhythmias. In the Framingham heart study, it was shown that in individuals with BPs ≥ 130/85 mmHg the risk of developing heart disease was triple that of patients with BPs < 120/80 mmHg. In addition, patients with hypertension often suffer from diabetes and dyslipidaemia (high cholesterol in the blood).

Further analysis of data from the Framingham heart study showed that 91% of patients with heart failure had a previous diagnosis of hypertension. A difference between biological sexes was also revealed: male hypertensive patients had a 2-fold increased risk of developing heart failure, whereas their female counterparts’ risk was 3-fold. In another study, a meta-analysis of 23 trials comprising 193 424 patients, it was determined that ‘the development of heart failure was found comparable with that of stroke [and] it is more prevalent in older, black, diabetic and ‘very high’ risk individuals’.

The take home? High blood pressure, or suffering from hypertension, means you are at increased risk of developing heart failure.

How the Hilo Band can help

The Hilo Band is a cuffless, wrist-worn device that takes blood pressure measurements continually, day and night. This unique approach, where a rich data-set is collected, allows patterns linked to sleep, stress, movement and recovery to be revealed. Data are presented in an easy-to-understand format, clearly showing peaks and troughs throughout the day.

Your daily BP rhythm can reveal key data about your overall health. In fact, while we often think of blood pressure as a single, static number – possibly because when BP is taken at the doctors, it’s often measured only once – it’s actually constantly fluctuating.

In a healthy individual, blood pressure will start to rise a few hours before we wake and will then continue upward until around midday, which is when it’s at its highest. BP tends to fall during the late afternoon into the evening, and should be at its lowest overnight. Irregular patterns of blood pressure include:

• high blood pressure during the night;
• overly high blood pressure early in the morning;
• a drop in blood pressure of less than 10% overnight (called “non-dipping”).

Regularly monitoring blood pressure using a Hilo Band has actually been shown to have a positive impact on BP data. Systolic blood pressure is known to rise with age, due to natural arterial stiffening, which is a key factor in older individuals being more likely to develop hypertension. However, using a Hilo Band changed this. Analysis of Hilo Band users showed that after six months of use, systolic BP was lower across all age-groups than at the start of their Hilo journey. Importantly, the size of this reduction increased with age: while all users appeared to benefit, the greatest decrease was seen among older users and, in some cases, the rise in systolic blood pressure was reversed.

Conclusion

Regularly monitoring blood pressure and ensuring that it stays within healthy limits – around 120/80 mmHg – will help protect your heart against heart failure or other serious cardiovascular conditions related to high blood pressure, such as heart attack or stroke. In fact, taking a measurement is the only way to know that you have hypertension, as it is almost always symptomless (which is why it’s known as the ‘silent killer’). Using a Hilo Band is an easy way to do this, and once set-up, the whole measurement process is entirely passive with no additional input required from the user.

Disclaimer: This article is not meant to replace a health practitioner’s advice. If you are concerned about your blood pressure or heart health, it is best to speak to your doctor. Only they can make a diagnosis and advise you on the next best step.

Frequently asked questions

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