Hypertension can wreck havoc on many body organs. Its effects on the heart are especially damaging. High blood pressure and heart disease are closely connected. Moderate to high blood pressure significantly increases the load on the left side of the heart. Arterioles are often diseased or constricted, which increases resistance to blood flow. When this happens, the heart has to work much more to pump blood into the arterial system including the aorta. When any muscle is overused, it tends to increase in size and bulk. The heart muscles react the same way. An enlarged heart is a sign of trouble. Heart enlargement can be detected in several ways. A chest x-ray can reveal it. So can an electrocardiogram or even a physical examination. In many high blood pressure patients, the walls of the left ventricle thicken. This increases the workload on the heart. Eventually, the heart falters and the left side of the heart no longer pumps blood adequately. When this happens, major organs and tissues of the body are denied sufficient blood supply. The affected person becomes lethargic and weak. Because of the higher pressure in the left ventricle, blood from the lungs cannot drain into the top compartment of the heart (the atrium). As a result, the lung tissues get congested which brings on bouts of breathlessness and coughs. The patient may have a dry cough or even frothy phlegm with blood stains in it. This is a very scary experience to the sufferer and onlookers. In an acute attack, it seems to the patient that he or she is choking to death. Breathlessness due to heart problems may be first noticed during prolonged physical exertion. If the condition has progressed further, breathlessness may occur even while resting. This is a serious situation and needs to be tacked immediately. If this damage worsens, the right side of the heart will be affected as well. When pressure builds up in the right atrium, it will be difficult for veins to drain blood into it. When the heart's condition deteriorates to this stage, the external jugular veins may become enlarged and more prominent. These veins are anyway close to the skin and may be visible even in healthy adults, but stress on the heart can increase their protrusion. There are several other symptoms of right side heart failure. They include an enlarged liver, swollen ankles and feet, loss of appetite, swollen abdomen and lower urine flow. High blood pressure and heart disease frequently have a cause and effect relationship. Making necessary lifestyle changes can help combat both.