"Silent" myocardial ischaemia in essential hypertension

During 16-h electrocardiographic monitoring of 29 patients with stage II (WHO) essential hypertension and left ventricular hypertrophy, the episodes of painless "silent" myocardial ischaemia were registered in 12. In these patients a bicycle ergometry test, transoesophageal atrial pacing, isotope ventriculography at rest and during isometric exercise, and coronary angiography in 3 cases, were performed. A comprehensive evaluation of findings revealed the presence of coronary insufficiency not accompanied by pain syndrome. Absence of angiographic signs of coronary stenosis in 3 patients subjected to coronary angiography suggests the presence of relative coronary insufficiency at least in these patients.