An excess of red blood cells in the body is known as polycythemia. The blood becomes thicker due to the additional cells, which raises the risk of blood clots and other health problems. There are various causes of polycythemia, and each one has a unique course of treatment. Discover more about polycythemia's causes, symptoms, and available treatments in this article. An rise in hemoglobin or hematocrit levels over the standard values is known as polycythemia. The majority of its causes are linked to the development of hyper viscosity, and the majority of cases are classified as primary or secondary polycythemia (SP). The underlying disease of the former, often referred to as polycythemia vera (PV), affects the bone marrow itself, whereas the latter is typified by an overabundance of stimulation of cell creation in the normal bone marrow. This study included patients who were diagnosed with PV or SP after undergoing additional testing at our hospital from January 2020 to December 2023 after polycythemia was discovered. The 2016 WHO criteria (hemoglobin > 16.5 mg/L for men and >16.0 mg/L for women, and/or hematocrit > 49% for men and >48% for women) were followed in determining the laboratory thresholds used to diagnose polycythemia. A case of PV exacerbated by cardiac hypertrophy is presented in this paper. It provides a full summary of the patient's long-term follow-up and a detailed account of their experience using antihypertensive medication. With an emphasis on clinical case studies, a thorough literature analysis was also carried out to look into any potential connections between PV and the risk of cardiovascular disease. The goal is to offer fresh viewpoints and understandings for evaluating cardiovascular risk and predicting prognosis in MPN patients. These findings have important ramifications for future clinical care guidelines in addition to improving our understanding of the relationship between PV and cardiovascular disease