Silent myocardial ischaemia in untreated essential hypertensives.
In hypertension, hypertrophy of the left ventricle might enhance the risk of ischaemia because of an augmented oxygen demand and an insufficient oxygen supply. The aims of the study were to estimate the prevalence of silent ischaemia in a group of untreated hypertensives with Holter monitoring and 3 different stress tests, and to look for a possible association between the presence of ischaemia and the blood pressure level as well as the left ventricular mass. The prevalence of silent ischaemia was tested in a group of 34 untreated hypertensives by Holter monitoring and by bicycle ergometer test, hyperventilation and captopril tests. 68% of the patients exhibited silent ischaemic periods during Holter monitoring. There was a trend towards a higher 24-hour SBP and DBP level in patients with ischaemia (p < 0.05), in addition to a tendency towards a higher catecholamine excretion in patients with ischaemia (p < 0.05), and a higher left ventricular mass (NS). Silent ischaemic episodes during ergometer exercise test were found in 27%. Only 3% had ischaemia during hyperventilation and captopril tests. In conclusion, the prevalence of ischaemia during the various stress tests was low, whereas Holter monitoring revealed signs of silent ischaemia in a substantial proportion of the patients. Patients with ischaemia tended to present more severe degrees of hypertension.
Schroeder
A P
AP
Department of Internal Medicine, Viborg Hospital, Denmark.
Brysting
B
B
Søgaard
P
P
Pedersen
O L
OL
D000328:Adult; D001794:Blood Pressure; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology* / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors