E1The question of stress cardiac insufficiency in hypertension

In a group of 91 patients with hypertensive vascular disease without any clinical symptoms and signs of cardiac insufficiency following pressures were measured at rest and during supine bicycle ergometer exercise: right atrial pressure, pulmonary artery pressure and pulmonary capillary wedge pressure (PCP). Cardiac output was measured by thermodilution at rest and during exercise. In 47 patients out of these 91 PCP was found to be normal and did not exceed 20 mm Hg during exercise, the remaining 44 patients developed pathologically raised PCP during exercise. The average cardiac output was normal at rest und during exercise. Those pathological PCP during exercise, which could be demonstrated in nearly 50% of all investigated hypertensive patients, reflect an elevation of left ventricular filling pressure, the reasons of which are briefly discussed.