"Silent" myocardial ischaemia in essential hypertension.

During 16-h electrocardiographic monitoring of 29 patients with stage II (WHO) essential hypertension and left ventricular hypertrophy, the episodes of painless "silent" myocardial ischaemia were registered in 12. In these patients a bicycle ergometry test, transoesophageal atrial pacing, isotope ventriculography at rest and during isometric exercise, and coronary angiography in 3 cases, were performed. A comprehensive evaluation of findings revealed the presence of coronary insufficiency not accompanied by pain syndrome.

The hypertensive heart: pathogenesis, variants, and prognostic value.

We examine the heart's involvement in arterial hypertension, reporting on several studies of hypertensive patients showing that left ventricular myocardial mass is a significant prognostic indicator of essential hypertension and that left ventricular hypertrophy (LVH) correlates with an induced increase in Ca2+ concentration in platelets. We also consider the LVH variant of asymmetric hypertrophy and the role of the hypertensive heart in coronary insufficiency, and we speculate on the significance of the degree of LVH and asymmetric hypertrophy as risk factors for predicting cardiac complications of essential hypertension.