Hypertensive Heart Disease: From Structure to Function The progression from hypertension to heart failure is marked by distinct, measurable stages: 1. Macrostructural Change: Pressure overload directly causes Left Ventricular Hypertrophy (LVH), the primary adaptive response that becomes a major predictor of sudden death and heart failure. 2. Functional Consequences: LVH leads to diastolic dysfunction, which results in: · Left Atrial Enlargement: A key biomarker of disease severity and the primar