The effects of high blood pressure on the heart
High blood pressure also affects the pump that tirelessly supplies our body with nutrients and oxygen 24 hours a day, seven days a week our heart.
The higher the pressure in the blood vessels is, the more force the heart must use to pump blood into the circulation against that pressure. The left ventricle in particular is forced to do extra work because it has to push blood into the body's circulation.
Because the heart is a muscle (more precisely a hollow muscle), the same thing happens to it as to any other muscle under strain: it grows.
The heart muscle especially the heart muscle fibers thickens, and more connective tissue forms between the muscle fibers. This makes the heart less flexible and stiffer. Unlike the enlargement seen in an athlete's heart, in a high-pressure heart also called hypertensive heart disease the heart's blood supply does not keep up with its growth. Also, the smaller arteries that supply the heart muscle are often narrowed. The muscle may not get enough oxygen and nutrients. This can cause symptoms such as chest pain (angina), even if the larger coronary arteries are not narrowed. If a coronary vessel becomes blocked due to progressive atherosclerosis, or if a blood clot lodges and closes the vessel, the area supplied by the downstream vessels can no longer get nutrients and oxygen. In that case, a heart attack has occurred.
Over time, a high-pressure heart can develop heart failure (a weakened heart muscle). The heart chambers enlarge and the heart can no longer pump a sufficient amount of blood from the left ventricle into the circulation. The amount of blood ejected decreases. To compensate, the heart will try to pump more often the heart rate increases. That, in turn, further wears out the damaged heart. Arrhythmias, such as atrial fibrillation, can also develop because of high blood pressure's effect on the heart.
When the heart enlarges, the valve leaflets do not grow with it, which can lead to valve insufficiency. That means the valve can no longer close properly and blood can flow backward.
Researchers found in 2025 that the heart diseases people die from most often have changed since 1970. A heart attack is no longer at the top. Treatment for heart attacks has become very successful, so more than 90% of those affected now survive. Instead, heart failure, arrhythmias and hypertensive heart disease are now leading the list.
Researchers found in 2025 that the heart diseases people die from most often have changed since 1970. A heart attack is no longer at the top. Treatment for heart attacks has become very successful, so more than 90% of those affected now survive. Instead, heart failure, arrhythmias and hypertensive heart disease are now leading the list.
Sources:
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 11/2025).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
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