Hypertension and the ischaemic myocardium.
Hypertension and ischaemic heart disease often co-exist. Recent studies, using ambulatory ST-segment and haemodynamic monitoring, have shown that myocardial ischaemia may not necessarily be accompanied by angina pectoris. Unless transient myocardial ischaemia is actively sought it may, therefore, be missed and this may have important prognostic and therapeutic implications. Studies investigating the use of beta-blockers, calcium antagonists and nitrates in angina pectoris have shown that these agents have an equal effect on painless as opposed to painful myocardial ischaemia. While there are no currently completed studies demonstrating the prognostic implication of silent ischaemia in stable angina, it is well known that approximately one-quarter of all myocardial infarctions occur without chest pain. Recent investigation in unstable angina showed that silent ischaemia was an important predictor of future coronary events.
Fox
K M
KM
National Heart Hospital, London, UK.
Levy
R D
RD
Mockus
L
L
Wright
C
C
D003327:Coronary Disease / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D004562:Electrocardiography; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008991:Monitoring, Physiologic; D011379:Prognosis; D012307:Risk Factors