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Left ventricular hypertrophy and myocardial ischaemia in hypertension: the THAMES Study

J E Otterstad1, M Davies, S G Ball

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

European Heart Journal
|December 1, 1993
PubMed

Insights

A study found that 68% of asymptomatic hypertensive men had left ventricular hypertrophy (LVH). Many with LVH also showed signs of myocardial ischemia, highlighting significant cardiovascular risk in this population.

Area of Science:

  • Cardiology
  • Epidemiology
  • Hypertension Research

Background:

  • Hypertension is a major risk factor for cardiovascular disease.
  • Left ventricular hypertrophy (LVH) is a common adaptation to chronic hypertension.
  • The prevalence of myocardial ischemia in asymptomatic hypertensive patients with LVH is not well-defined.

Purpose of the Study:

  • To determine the prevalence of left ventricular hypertrophy (LVH) in asymptomatic male hypertensive patients.
  • To assess the prevalence of myocardial ischemia in hypertensive patients with LVH.
  • To evaluate the diagnostic utility of exercise ECG and thallium-201 scintigraphy in detecting ischemia.

Main Methods:

  • Multicentre epidemiological study involving 188 asymptomatic male hypertensives.
  • Echocardiography used to diagnose LVH (LV mass index > or = 130 g.m-2).
  • Maximal bicycle ergometer exercise test and exercise thallium-201 scintigraphy performed on patients with LVH.

Main Results:

  • LVH was detected in 127 (68%) of the participants.
  • Significant ST depression on exercise ECG, suggestive of ischemia, was found in 29 men (23%) with LVH.
  • Exercise thallium-201 scintigraphy revealed reversible perfusion defects in 15 of these subjects (52% of those tested).

Conclusions:

  • A high prevalence of LVH exists in hypertensive men selected based on age and blood pressure.
  • A substantial proportion of hypertensive men with LVH exhibit signs of stress-induced myocardial ischemia.
  • These findings underscore the importance of screening for LVH and ischemia in hypertensive patients.

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