The precise role that abnormal wall stress may play in the pathophysiology
of hypertensive heart disease is not known. Hypertension is almost unique i
n that it ultimately affects all parts of the law of Laplace equation, i.e.
intraventricular pressure changes and with the advent of left ventricular
hypertrophy both internal radius and wall thickness alter. If heart failure
supervenes the components of the equation change once more. This article w
ill discuss the implications of abnormal wall stress at these various stage
s in hypertensive heart disease.