[Arterial hypertension and sudden cardiac death]

Prevalence and severity of arterial hypertension in 345 sudden cardiac death (SCD) cases have been assessed basing on post-mortem morphologic examination of the kidneys involving special staining and quantitation of renal arteriolar lesion. Incidence rate for arterial hypertension was determined both for the whole group of cases and subgroups recognized by a variant of myocardial damage, i.e. alcoholic cardiomyopathy, recent myocardial infarction, thrombosis, microfocal or postinfarction cardiosclerosis. SCD was found to be closely associated with arterial hypertension, evidenced by common parenchymal affections similar to chronic pyelonephritis, or rare diabetic glomerulosclerosis. The occurrence and severity of arterial hypertension varied for different subgroups, being a more frequent finding in microfocal versus postinfarction cardiosclerosis and thrombosis (52.6, 31.6 and 28.2%, respectively), and minimal in alcoholic cardiomyopathy. Comparison of arterial hypertension severity and chronic pyelonephritis incidence for the two most numerous groups demonstrated the gravest condition in postinfarction cardiosclerosis than in microfocal one. The potential role of arterial hypertension in the mechanism of cardiac sudden death is discussed.