[Diagnostic value of exercise testing in the diagnosis of silent myocardial ischemia in elderly patients with systolic hypertension].
OBJECTIVE
To evaluate the diagnosis value of exercise testing for silent myocardial ischemia in systolic hypertension of the elderly.


METHODS
We compared 110 patients with systolic hypertension (group A) with 104 patients without hypertension (group B). They were submitted to an exercise test according to the Bruce protocol, between January/91 to December/94. Exercise was discontinued if target heart rate was achieved, or fatigue, dyspnea, severe arrhythmia, hypotension or significant ST segment depression > or = 2 mm/0.2 mV developed.


RESULTS
Exercise testing showed ischemic ST depression in 22 (20%) of the elderly patients with hypertension systolic and 12 (11.5%) of control elderly patients. The exercise time was shorter in the hypertensives 7.1 +/- 2.9 min vs 8.8 +/- 2.5 min. The ST depression was greater in the hypertensives than the control group: 2.5 +/- 0.8 min vs 1.9 +/- 0.4 min. Also the duration or ischemic ST depression was longer in the hypertensive patients than the control group 5.4 +/- 2.8 min vs 3.4 +/- 1.9 min.


CONCLUSIONS
Elderly hypertensive patients with systolic hypertension have more silent myocardial ischemia than elderly without hypertension. Among the elderly hypertensive patients there was a prevalence of silent ischemia that was 1.7 times higher than in the normotensive elderlies (20% vs 11.5% P < 0.003).
de Oliveira
J J
JJ
Hospital das Clínicas, Faculdade de Medicina da UFG, Goiânia.
Silva
S R
SR
D000368:Aged; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis; D017202:Myocardial Ischemia / Q000175:diagnosis*
Valor diagnóstico do teste ergométrico na detecção da isquemia miocárdica silenciosa no paciente idoso com hipertensão sistólica.