Diagnosis and management of diastolic dysfunction in arterial hypertension.

Diastolic dysfunction (DD) refers to impaired relaxation or filling of the ventricles during the diastolic phase of the cardiac cycle. Left ventricular (LV) DD is common in hypertensive individuals and is associated with increased morbidity and mortality, particularly heart failure with preserved ejection fraction (HFpEF). The pathophysiology of DD involves alterations in cardiac structure and function, neurohormonal activation, and vascular stiffness. Diagnosis is primarily based on echocardiography, and there are no specific treatment guidelines. Recently, treatments such as sodium-glucose cotransporter 2 inhibitors (SGLT2i), GLP-1 receptor agonists, and finerenone have emerged, which may offer benefits in diastolic dysfunction and HFpEF. This review aims to present the pathophysiological mechanisms of DD in hypertension (HTN), its diagnosis, and its treatment.