Hypertension and myocardial ischemia

Murphy, Brian P., Stanton, Tony and Dunn, Francis G. (2009) Hypertension and myocardial ischemia. Medical clinics of North America, 93 3: 681-695. doi:10.1016/j.mcna.2009.02.003


Author Murphy, Brian P.
Stanton, Tony
Dunn, Francis G.
Title Hypertension and myocardial ischemia
Journal name Medical clinics of North America   Check publisher's open access policy
ISSN 0025-7125
1557-9859
Publication date 2009-05-01
Year available 1987
Sub-type Article (original research)
DOI 10.1016/j.mcna.2009.02.003
Open Access Status
Volume 93
Issue 3
Start page 681
End page 695
Total pages 16
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Language eng
Subject 2700 Medicine
Abstract There is an impressive evidence base for the presence of myocardial ischemia in patients who have hypertension. This relationship ranges from the obvious association with obstructive coronary artery disease to more subtle mechanisms related to hemodynamic, microcirculatory, and neuroendocrine abnormalities. All of these factors serve to destabilize the critical balance between myocardial oxygen supply and demand. We have at our disposal a range of sophisticated investigations that allow us to demonstrate the presence and extent of the ischemia and therefore to target specific therapies to reduce the risk to these patients. Achieving target blood pressure and managing all reversible components of the patient's cardiovascular risk status help to minimize the clinical sequelae of myocardial ischemia in this vulnerable population.
Formatted abstract
Hypertension is an established major risk factor for the clinical syndromes associated with CAD, and therefore has dominated thinking in regard to its known association with myocardial ischemia. Its importance as a risk factor is proven by an impressive epidemiologic base1 and applies to angina, myocardial infarction, and sudden death. The relationship strengthens with higher blood pressure levels and when left ventricular hypertrophy (LVH) coexists as identified by ECG2,3 or by echocardiography (ECHO).4 The cause of these clinical events is often presumed to be obstructive epicardial CAD, but this may not always be the case because there are many factors in hypertension that contribute to these clinical events. This article explores the various ways in which hypertension can produce or contribute to myocardial ischemia.
Keyword Hypertension
Ischemia
Perfusion
Mechanisms
Management
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Thu, 03 Sep 2009, 17:58:57 EST by Mr Andrew Martlew on behalf of Medicine - Princess Alexandra Hospital