Microvascular angina in systemic hypertension: diagnosis and treatment with enalapril.
The causes of hypertensive microvascular ischemia are reviewed along with diagnostic factors. Stress/rest thallium-201 scintigraphy is shown to have a predictive value of 78% for a diagnosis of microvascular disease in hypertensive patients with exertional angina and left ventricular hypertrophy. Lack of isotope uptake at peak stress correlates well with the decrease in coronary flow reserve in ischemic segments, which is 2-3 times lower than in normal subjects. Treatment with enalapril produces regression of left ventricular hypertrophy, normalization of thallium-201 uptake, and an increase in exercise capacity in patients with microvascular angina.
D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003326:Coronary Circulation / Q000187:drug effects; D004656:Enalapril / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D008833:Microcirculation / Q000187:drug effects; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D013794:Thallium Radioisotopes; D004656:Enalapril