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[ST-segment depressions correlate in patients with hypertensive heart disease with spontaneous changes in blood
Insights
In hypertensive patients with angina, ST-segment depressions often correlate with elevated blood pressure and heart rate. These findings suggest a pathological link between hypertension and cardiac events.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Electrophysiology
Context:
- Essential hypertension and anginal pain are common clinical presentations.
- Coronary artery disease was excluded via angiography in the study cohort.
- Continuous 24-hour monitoring of ST-segment and blood pressure was employed.
Purpose:
- To investigate the relationship between ST-segment depression, blood pressure, and heart rate in patients with essential hypertension and angina.
- To determine the patho-physiological significance of ST-segment changes in this patient group.
Summary:
- ST-segment depressions (≥0.1 mV) were observed in 11 out of 15 patients.
- Elevated blood pressure (>150/95 mm Hg or >20% increase) occurred during 10 of 26 ST-segment depression episodes.
- Increased heart rate (>20%) accompanied 20 of 26 ST-segment depressions.
- A positive correlation was found between blood pressure (diastolic and systolic) and the extent of ST-segment depression.
- Angina pectoris was reported during 9 ST-segment depression periods and in 27 additional anginal attacks without ST changes.
Impact:
- The study highlights a significant correlation between blood pressure fluctuations and ST-segment changes in hypertensive patients with angina.
- Findings suggest that ST-segment depressions in this population may have a direct patho-physiological relevance.
- This research may inform diagnostic and therapeutic strategies for managing hypertensive patients experiencing anginal symptoms.
Abstract:
In 15 patients with essential hypertension, anginal pain, and angiographically excluded coronary artery disease 24-h monitoring of the ST-segment and blood pressure was performed. 26 episodes with ST-segment depressions 0400.1 mV were recorded in 11/15 patients. In 10/26 episodes with ST-segment depressions blood pressure was elevated above 150/95 mm Hg or by more than 20% as compared to three successive measurements before the ST-segment depressions. Heart rate was increased by more than 20% in 20/26 ST-segment depressions. During 9 periods with ST-segment depressions angina pectoris was reported; in addition 27 anginal attacks without ST-segment depressions were observed. A significant, positive correlation between the diastolic (p less than 0.005) and systolic (p less than 0.02) blood pressure and the extent of the ST-segment depression was observed. These correlations imply a patho-physiological meaning of ST-segment depressions in hypertensive patients.