Hypertensive heart disease includes a number of complications of high blood pressure that affect the heart. While there are several definitions of hypertensive heart disease in the medical literature, the term is most widely used in the context of the International Classification of Diseases (ICD) coding categories. The definition includes heart failure and other cardiac complications of hypertension when a causal relationship between the heart disease and hypertension is stated or implied on the death certificate. In 2013 hypertensive heart disease resulted in 1.07 million deaths as compared with 630,000 deaths in 1990.According to ICD-10, hypertensive heart disease (I11), and its subcategories: hypertensive heart disease with heart failure (I11.0) and hypertensive heart disease without heart failure (I11.9) are distinguished from chronic rheumatic heart diseases (I05-I09),  other forms of heart disease (I30-I52) and ischemic heart diseases (I20-I25). However, since high blood pressure is a risk factor for atherosclerosis and ischemic heart disease, death rates from hypertensive heart disease provide an incomplete measure of the burden of disease due to high blood pressure. Signs and symptoms
The symptoms and signs of hypertensive heart disease will depend on whether or not it is accompanied by heart failure.
In the absence of heart failure, hypertension, with or without enlargement of the heart (left ventricular hypertrophy) is usually symptomless.Symptoms, signs and consequences of congestive heart failure can include:

Fatigue
Irregular pulse or palpitations
Swelling of feet and ankles
Weight gain
Nausea
Shortness of breath
Difficulty sleeping flat in bed (orthopnea)
Bloating and abdominal pain
Greater need to urinate at night
An enlarged heart (cardiomegaly)
Left ventricular hypertrophy and left ventricular remodeling
Diminished coronary flow reserve and silent myocardial ischemia
Coronary heart disease and accelerated atherosclerosis
Heart failure with normal left ventricular ejection fraction (HFNEF), often termed diastolic heart failure
Atrial fibrillation, other cardiac arrhythmias, or sudden cardiac deathHeart failure can develop insidiously over time or patients can present acutely with acute heart failure or acute decompensated heart failure and pulmonary edema due to sudden failure of pump function of the heart. Sudden failure can be precipitated by a variety of causes, including myocardial ischemia, marked increases in blood pressure, or cardiac arrhythmias. Diagnosis
Differential diagnosis
Other conditions can share features with hypertensive heart disease and need to be considered in the differential diagnosis. For example:
Coronary artery disease or ischemic heart diseases due to atherosclerosis
Hypertrophic cardiomyopathy
Left ventricular hypertrophy in athletes
Congestive heart failure or heart failure with normal ejection fraction due to other causes
Atrial fibrillation or other disorders of cardiac rhythm due to other causes
Sleep apnea

Prevention
Because there are no symptoms with high blood pressure, people can have the condition without knowing it.