Most patients with hypertension can develop heart failure. In the Framing Heart Study hypertension preceded the development of heart failure in about 91% of new-onset heart failure during at least mean follow-up of 14.1 years. When other risk factors were accounted for, hypertension increased the risk for heart failure two-fold in men and three-fold in women. Multivariate analysis demonstrated a large population-
attributable risk of hypertension for heart failure accounting for 39% of cases in men and 59% of cases in women. Patients with hypertension whom also had diabetes mellitus, myocardial infarction, left ventricular hypertrophy and valvular disease had an increased risk of heart failure. In the Framingham Heart Study, the life-time risk of heart failure was about 20% (one in five) in both sexes and this risk can double with a blood pressure of 160/100§mmHg as compared to a blood pressure of 140/90 mmHg.