What should you know about hypertensive heart disease with congestive heart failure?

High blood pressure makes the heart pump against greater resistance. Over time, the heart muscle may become stiff or enlarged and may not fill or pump efficiently. Heart failure means the heart cannot meet the body's needs as well as it should; it does not mean that the heart has stopped. Fluid can build up in the lungs or tissues, causing breathlessness, cough, fatigue or swollen ankles. Atrial fibrillation can also affect rhythm and how efficiently the heart pumps. Symptoms vary, so a clinical assessment is needed.

Take heart and blood pressure medicines exactly as prescribed, and do not change doses when symptoms improve without advice. Attend chronic disease reviews so clinicians can check blood pressure, kidney function, rhythm, weight and signs of fluid retention. Follow your personal guidance on salt, fluids and activity. Note new breathlessness, night-time symptoms, ankle swelling, cough, palpitations and changes in exercise tolerance. Keeping a simple symptom record can help identify a gradual change before it becomes severe.

Call emergency services for severe breathlessness at rest, chest pain, fainting, new confusion, blue lips or a sudden severe weakness. Seek prompt medical advice for rapidly worsening swelling, a new persistent cough, fast or irregular palpitations, or a clear change in your usual ability to walk or climb stairs. Do not wait for a routine appointment if symptoms are escalating.

Ask which symptoms suggest fluid build-up, how to follow your fluid or salt plan, which medicines require kidney checks, and whom to contact if your weight or breathing changes.