Topic overview

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Chronic pressure load can produce concentric left ventricular hypertrophy, with impaired relaxation and filling arising before later systolic dysfunction. Hypertension also contributes to aortic medial degeneration and accelerated atherosclerosis in large arteries. In small vessels, benign hypertension is associated with hyaline arteriolosclerosis, while malignant hypertension may involve hyperplastic arteriolitis and necrotizing injury. Renal, cerebral, and retinal findings reflect these vascular effects: kidney injury may progress slowly or present acutely, and brain complications include ischemia or hemorrhage. Retinal vascular changes provide additional signs of target-organ involvement. The lesson connects these manifestations with hypertensive emergencies, pregnancy-related considerations, endothelial dysfunction, and the role of damage to major organs in prognosis.