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The development of coronary insufficiency during prolonged treatment of essential hypertension
U V Kalnins1, I J Skarda, D J Liepinja
1Latvian Research Institute of Cardiology, Riga, USSR.
Insights
Essential hypertension treatment can lead to coronary insufficiency, including angina and myocardial infarction. Even with normalized blood pressure and reduced heart muscle thickening, coronary issues may still arise.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Medicine
Background:
- Essential hypertension is a major risk factor for cardiovascular disease.
- Left ventricular myocardial hypertrophy is a common complication of hypertension.
- Long-term antihypertensive therapy aims to prevent cardiovascular events.
Purpose of the Study:
- To analyze the occurrence of coronary insufficiency signs during prolonged combined treatment of essential hypertension.
- To investigate the relationship between left ventricular myocardial hypertrophy and coronary events.
- To assess the impact of antihypertensive therapy on coronary insufficiency in hypertensive patients.
Main Methods:
- Analysis of 42 patients with essential hypertension and left ventricular myocardial hypertrophy.
- Four-year follow-up of antihypertensive therapy.
- Assessment of angina pectoris, myocardial infarction, and ischemic ECG changes (bicycle ergometry, transesophageal atrial pacing).
Main Results:
- 17% developed angina pectoris, 7% had myocardial infarction, and 36% showed ischemic ECG changes.
- In patients with insufficient blood pressure control and severe hypertrophy, coronary insufficiency occurred in 53%.
- Stable pressure normalization and hypertrophy regression did not prevent coronary insufficiency.
Conclusions:
- Prolonged antihypertensive treatment in patients with myocardial hypertrophy carries a risk of coronary insufficiency.
- Inadequate blood pressure control exacerbates this risk.
- Coronary insufficiency can develop even with normalized blood pressure and hypertrophy regression, including during beta-blocker therapy.
Abstract:
The occurrence of signs of coronary insufficiency during prolonged combined treatment of essential hypertension was analysed in a selected group of 42 patients with left ventricular myocardial hypertrophy. During a four-year antihypertensive therapy 17% of patients developed angina pectoris on effort myocardial infarction occurred in 7%, and ischaemic ECG changes during bicycle ergometry or transoesophageal atrial pacing were detected in 36%. In the subgroup with an insufficient hypotensive effect and sustained severe myocardial hypertrophy the signs of coronary insufficiency occurred in 53%. Nevertheless, the attainment of a stable pressure normalization and regression of myocardial hypertrophy does not exclude the development of coronary insufficiency, even in patients treated with beta-adrenoblocking drugs.