HYPERTENSION AND SILENT-MYOCARDIAL-ISCHEMIA - THEIR INFLUENCE ON CARDIOVASCULAR MORTALITY AND MORBIDITY

被引:5
作者
HEDBLAD, B
JANZON, L
机构
关键词
HYPERTENSION; SILENT MYOCARDIAL ISCHEMIA; ST-SEGMENT DEPRESSION; AMBULATORY ELECTROCARDIOGRAPHY;
D O I
10.1159/000177043
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The presence of ST-segment depression during ambulatory electrocardiographic monitoring, in relation to blood pressure treatment and control, was monitored in a non-randomized study in 167 men (49%) from the 'Men born in 1914' Malmo study, who were considered to have hypertension (diastolic blood pressure [DBP], greater than or equal to 95 mm Hg or receiving antihypertensive therapy). Men were excluded if they had a history of ischemic heart disease. A high frequency of ST-segment depression (41%) and associated high cardiac event rate (14%) were found in hypertensive elderly men who had inadequately controlled blood pressure (i.e. DBP greater than or equal to 95 mm Hg). This was associated with a relative risk of a cardiac event of 9.8 (95% confidence interval: 2.6-36.9), even after adjustment for smoking, blood lipids and alcohol consumption. The lower frequency of ST-segment depression (21%) and lower cardiac event rate (5%) in hypertensive men with adequate blood pressure control suggests that effective antihypertensive treatment leads to a reduced event rate. In conclusion, the occurrence of ST-segment depression during ambulatory electrocardiographic monitoring in this group of subjects may be an expression of silent myocardial ischemia, with or without left ventricular hypertrophy. The incidence of asymptomatic ST-segment depression and the rate of cardiac events in hypertensive patients may be, in part, related to the level of blood pressure control attained.
引用
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页码:16 / 23
页数:8
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