Hypertension and Coronary Occlusion

Abstract

The problem of the r'elationship between hypertension and coronary occlusion has been r'e-examined. Using newly established limits of hypertension, 600 consecutive private patients with coronary occlusion-500 men and 100 women-all under 65 years of age, were studied. Hypertension did not appear to be a factor in producing coronary disease and occlusion among men, but was a definite factor in its causation among women. The possible relation of the serum cholesterol, the Sf 12-20 lipoprotein fraction, and the sex hormones to atherosclerosis and hypertension is discussed.E VER since coronary occlusion became a well recognized clinical entity, many writers have suggested that hypertension was a common antecedent of the condition in both men and women, and a significant factor in its etiology. had suffered from hypertension before the coronary artery occlusion had occurred. From the foregoing reports, it appeared that hypertension was an important predisposing factor in coronary occlusion, particularly in the older age groups and especially in women. Apparent confirmation of this opinion was found in the greater incidence of "hypertension" in patients with coronary occlusion than in the general population.'0 19, 26 Thus, for example, in the study to which reference was just made, "hypertension" was found to be four or five times more frequent in the 25 to 54 year age group of males and females with coronary occlusion, and two to three times more frequent in the 55 to 74 year group, than it was among the general population.However, even in 1939, Master, Jaffe and Dack14 emphasized the fact that hypertension was not the only etiologic factor in coronary occlusion, since the majority of patients under 45 was not hypertensive. Durant27 and also Franklin28 questioned the relationship between hypertension and coronary occlusion. In retrospect, it seems obvious that the premise that "hypertension" caused coronary occlusion was untenable, since one definition of hypertension was applied to all ages and to both sexes. Furthermore, in the cited report of Master, Jaffe and Dack'4 the prognosis wsas found to be the same, whether hypertension wAas o0 s-as not present. Conner and Holt,5 as Asell as many others 4, 14, 16,[21][22][23][29][30][31][32] had also found that the occurrence of hypertension Asas of no significance in the prognosis of coronary thrombosis.It is 1now our opinionI that the conclusions formerly reached (ollcerlnig the relationship of hypertension to coroniary occlusion are not valid. "High" systolic and diastolic blood presCirculation, Volume

Studies on Age and Sex Incidence of Various Diseases Resulting From Atherosclerosis

“…Approximately 37 per cent of the males and 62 per cent of the females had a history of hypertension. These findings correspond well with those for hypertension in patients with myocardial infarction (22).…”

Incidence of Various Types of Cardiovascular Diseases by age Group in the Male and in the Female†

“…Thirty‐three (67 per cent) of the 49 females and twenty‐five (32 per cent) of the 78 males had a history of moderate to severe hypertension preceding the infarction. These results are in good agreement with the study of hypertension and coronary occlusion recently reported by Master (56). He found that 28 (70 per cent) of 40 women below the age of 55 with myocardial infarction had hypertension, and 26 per cent of the males with myocardial infarction before the age of 55 had a history of hypertension.…”

Autopsy Studies in Atherosclerosis

“…Although hypertension has usually been associated with increased atherosclerosis in both sexes, this has been especially true in women. 25 Hypertension in the men in our study was associated with an increased degree of atherosclerosis in their coronary and cerebral vessels, and with a greater occurrence of cardiac catastrophes. This association was even more marked, and involved more arteries, among women with hypertension.…”