Causes

Heart failure has many causes and can evolve in different ways.

• It can be a direct, latest-stage result of heart damage from one or more of several heart or circulation diseases.
• It can occur over time as the heart tries to compensate for abnormalities caused by these conditions, a condition called remodeling.

In all cases, the weaker pumping action of the heart means that less blood is sent to the kidneys. The kidneys respond by retaining salt and water. This in turn increases edema (fluid buildup) in the body, which causes widespread damage.

High Blood Pressure

Uncontrolled high blood pressure (hypertension) is a major cause of heart failure even in the absence of a heart attack. In fact, about 75% of cases of heart failure start with hypertension. It generally develops as follows:

• The heart muscles thicken to make up for increased blood pressure.
• The force of the heart muscle contractions weaken over time, and the muscles have difficulty relaxing. This prevents the normal filling of the heart with blood.

[For more information, see In-Depth Report #14:High blood pressure.]

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Review Date: 05/04/2011
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)