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Ischaemia and left ventricular hypertrophy

J E Otterstad1

  • 1Medical Department, Vestfold Central Hospital, Toensberg, Norway.

European Heart Journal
|October 1, 1993
PubMed

Insights

Hypertension often leads to left ventricular hypertrophy (LVH), increasing the risk of myocardial ischemia. This study found a high prevalence of ischemia in hypertensive patients with LVH, suggesting a need for targeted treatment.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • Left ventricular hypertrophy (LVH) is common in hypertensive patients.
  • LVH and myocardial ischemia pose significant risks, especially when co-occurring in hypertension.
  • The THAMES study investigated the prevalence of ischemia in this high-risk group.

Purpose of the Study:

  • To determine the prevalence of myocardial ischemia in hypertensive patients with LVH.
  • To assess the diagnostic utility of exercise ECG and thallium scintigraphy in this population.

Main Methods:

  • The Tenormin in Hypertension and Myocardial Ischaemia Epidemiological Survey (THAMES) included 205 hypertensive men.
  • Echocardiography diagnosed LVH (left ventricular mass index >= 130 g m-2).
  • Exercise ECG and thallium scintigraphy identified myocardial ischemia.

Main Results:

  • LVH was present in 68% of hypertensive patients (140/205).
  • Myocardial ischemia was diagnosed in 24% of LVH patients via exercise ECG.
  • Thallium scintigraphy detected ischemia in 14% of LVH patients.

Conclusions:

  • Hypertensive patients with LVH exhibit a notable prevalence of myocardial ischemia.
  • Reversing LVH and reducing ischemia are logical therapeutic goals.
  • While ACE inhibitors are effective for LVH regression, beta-blockers offer anti-ischemic benefits.

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