[From hypertension to heart failure-a pathophysiological continuum].

The heart failure syndrome is one the most common chronic diseases in western countries with poor prognosis. In view of the estimated aging of our society, it will gain further importance. Hypertension and/or myocardial infarction are the main causes of chronic heart failure, accounting for about three quarters of the cases. In hypertension, pressure overload of the heart leads to an increase in wall stress. This frequently results in cardiac hypertrophy, which is induced by the mechanical stress on the cardiomyocytes and the activation of neuroendocrine mechanisms, particularly the renin-angiotensin-aldosterone system and the sympathetic nervous system. Myocardial hypertrophy represents an independent risk factor for cardiovascular events and is a powerful predictor for the development of heart failure. The signal transduction pathways leading to the transition from compensated hypertrophy to heart failure are subject of intensive research. The knowledge of the maladaptive signaling pathways may be the basis for new therapeutic strategies in the prevention and management of heart failure.