Doctors often compare the heart to a pump, and heart failure, in layman’s terms, means that this pump is underpowered. Heart failure is not an isolated disease; it is a mid- to late-stage manifestation of many types of heart disease. Many heart diseases, including hypertension, will eventually show symptoms of heart failure if they are not scientifically treated and controlled. Patients with heart failure will experience various kinds of swelling and the appearance of dyspnea with significant shortness of breath. But in fact, before these symptoms of edema and shortness of breath appear, the patient’s heart structure and function have been wrong for a long time. Hypertension is the main cause of heart failure (men: 39%, women: 59%). Long-term elevated blood pressure induces or promotes the development of cardiac remodeling, which manifests as hypertrophy or dilation of the heart, with or without signs and symptoms of heart failure. Left ventricular hypertrophy is an adaptive change in the heart in response to prolonged hypertension, and the remodeling of cardiac structure increases the risk of heart failure. Myocardial fibrosis is the most important structural abnormality of left ventricular hypertrophy. Approximately 40% of patients with hypertension die from heart failure. According to the Framinghan study, a 20 mmHg increase in blood pressure is associated with a 56% increased risk of chronic heart failure. Aggressive blood pressure lowering up to the standard can reduce the risk of heart failure by 52%. In addition to the stimulus of elevated blood pressure, activation of the neuroendocrine system, particularly the renin-angiotensin-aldosterone (RAS) system, plays a central role in hypertension-induced left ventricular hypertrophy. Aggressive antihypertensive therapy is the key to prevent hypertensive heart disease, left ventricular hypertrophy, and heart failure. With 160 million hypertensive patients in China, the low treatment rate and low compliance rate will be huge for the future heart failure population if the status quo is not changed.