[Blood pressure variability and transient myocardial ischemia in patients with essential hypertension].
To determine whether myocardial ischemia is accompanied by variation in heart rate and/or blood pressure, ST-segment analysis on Holter-ECG and ambulatory blood pressure monitoring was performed in 78 patients (64 males/14 females) with essential hypertension. Thirteen out of 55 patients (24%) with angiographically proven coronary artery disease (CAD) showed ST-segment depression (ST-D; group A pos). We observed 41 ST-D (1-11 ST-D; median: 2) lasting from 1 min to 70 min 15 s (median: 4 min 42 s) and an average depression of 185 +/- 48 mV. In comparison, in 6 of 23 patients (26%) with a normal angiogram 24 ST-D (1-10; median: 3; group B pos), which showed longer duration (1 min to 109 min 20 s; median: 11 min 10 s) and less depression (137 +/- 47 mV) have been found. 73.3% of all ST-D in group A pos and all in group B pos were preceded by an average increase in heart rate of 13 bpm. Exclusively, 12 episodes of ischemia (29.3%) in patients with CAD and 8 (33.3%) in patients without CAD were accompanied by an increase in blood pressure, which was more distinct in group A pos. Transient myocardial ischemia can be shown in hypertensive heart disease unrelated to CAD. A clear correlation between an increase in blood pressure and ST-D could not be proven.
Lanitz
E C
EC
Abt. für Kardiologie und Pulmonologie, Medizinische Universitätsklinik Göttingen.
Gonska
B D
BD
Schrader
J
J
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D015924:Blood Pressure Monitors; D002940:Circadian Rhythm / Q000187:drug effects / Q000502:physiology*; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology*; D015716:Electrocardiography, Ambulatory / Q000187:drug effects / Q000295:instrumentation; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation
D000959:Antihypertensive Agents
Blutdruckvariabilität und transiente Myokardischämien bei Patienten mit Essentieller Hypertonie.