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Silent ST depression and cardiovascular end-organ damage in newly found, older hypertensives

W F Terpstra1, J F May, A J Smit

  • 1Department of Cardiology/Thoraxcenter, University Hospital Groningen, The Netherlands. w.f.terpstra@castel.nl.

Hypertension (Dallas, Tex. : 1979)
|April 17, 2001
PubMed

Insights

Silent myocardial ischemia, indicated by ST-segment depression, affects about 12% of older hypertensive patients. Vascular factors, not cardiac factors, primarily influence its occurrence in this group.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Biology

Background:

  • Hypertension contributes to myocardial ischemia through reduced vascular supply and increased cardiac demand.
  • Silent myocardial ischemia is a significant concern in untreated hypertensive individuals.

Purpose of the Study:

  • To determine the prevalence of ST-segment depression in asymptomatic, previously untreated, older hypertensive patients.
  • To analyze the contributing vascular and cardiac factors associated with silent myocardial ischemia in this population.

Main Methods:

  • A population survey identified 184 mild hypertensive patients (aged 60-75) without prior treatment.
  • Cardiovascular end-organ damage was assessed, including intima-media thickness and arterial plaques via B-mode ultrasound.
  • Forty-eight-hour ambulatory Holter monitoring was used to detect episodes of ST-segment depression.

Main Results:

  • ST-segment depression, indicative of silent myocardial ischemia, was observed in 21 patients (12%).
  • Patients with ST depression exhibited significantly higher intima-media thickness and more arterial plaques compared to those without.
  • Left ventricular mass index did not significantly differ between groups, but a correlation was found between left ventricular mass and ischemic burden in those with ST depression.

Conclusions:

  • Approximately 12% of older, untreated hypertensive individuals experience asymptomatic ST-segment depression.
  • Vascular factors, such as arterial wall thickening and plaques, appear to be the primary determinants of ST-segment depression occurrence.
  • Cardiac factors, specifically left ventricular mass, correlate with the severity of the ischemic burden in these patients.

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