How does hypertension affect the heart?

• A. By making free radicals hit the heart.
• B. By stressing the heart oxidatively.
• C. By increasing the blood sugar level.
• D. By making the heart work much harder.

Answer: (D)

Hypertension raises the pressure the heart has to pump against, increasing afterload. Because the heart must push blood into higher resistance vessels, it contracts harder and longer to maintain circulation. This extra workload causes the heart muscle, especially the left ventricle, to thicken (left ventricular hypertrophy), become less compliant, and require more oxygen. Over time, these changes can lead to ischemia, diastolic dysfunction, arrhythmias, and eventually heart failure if the high blood pressure isn’t controlled. The option that describes the heart working much harder captures this direct mechanical effect. The other choices mention factors like oxidative stress or metabolic changes that aren’t the primary way hypertension affects how the heart functions on a daily basis.