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.
As the condition progresses, heart failure (weakness of the heart muscle) can develop in a heart affected by high blood pressure. The heart's chambers enlarge, and the heart is no longer able to pump enough blood from the left ventricle into the circulation. Its pumping capacity decreases. To compensate for this, the heart will try to pump more often - the heart rate increases. This in turn further tires the damaged heart. Cardiac arrhythmias such as atrial fibrillation can also develop in this way due to the effects of high blood pressure 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 is from Tensana – the leading app since 2011, helping hundreds of thousands of people 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 outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
