Established cardiac fibrosis (ECF) with symptomatic heart failure preserved ejection fraction represents an ever-increasing segment of the hypertensive population. The regression of ECF with attendant improvement in myocardial stiffness and symptomatic failure represents an unmet health care need. Is the regression of ECF in hypertensive heart disease feasible and will stiffness and symptomatic failure be improved? What is the cellular/molecular signaling involved in its regression? What incremental knowledge is needed to proceed effectively? These issues are addressed in this Review.
Keywords: blood pressure; cardiac fibrosis; hypertension; hypertensive heart disease; molecular signaling with fibrogenic and fibrolytic axes; myocardial stiffness; myofibroblast secretome.
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