Hypertension and Myocardial Ischemia

Murphy, Brian P.; Stanton, Tony; Dunn, Francis G.

doi:10.1016/j.mcna.2009.02.003

Cited by 33 publications

(15 citation statements)

References 88 publications

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“…Hypertension is related to increased sympathetic activity [19], [42] and is a risk factor of cardiac events such as arrhythmia [20] and ischemic changes [20], [43]. In our study, untreated hypertensive men had higher HR and LF/HF- ratio and lower T-wave amplitude compared to controls in both warm and cold conditions, consistent with previous non-cold related studies [44], [45] and indicating elevated sympathetic activity in hypertension.…”

Section: Discussionsupporting

confidence: 90%

Cardiac Repolarization and Autonomic Regulation during Short-Term Cold Exposure in Hypertensive Men: An Experimental Study

et al. 2014

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ObjectivesThe aim of our study was to assess the effect of short-term cold exposure, typical in subarctic climate, on cardiac electrical function among untreated middle-aged hypertensive men.MethodsWe conducted a population-based recruitment of 51 hypertensive men and a control group of 32 men without hypertension (age 55–65 years) who underwent whole-body cold exposure (15 min exposure to temperature −10°C, wind 3 m/s, winter clothes). Conduction times and amplitudes, vectorcardiography, arrhythmias, and heart rate variability (autonomic nervous function) were assessed.ResultsShort-term cold exposure increased T-peak to T-end interval from 67 to 72 ms (p<0.001) and 71 to 75 ms (p<0.001) and T-wave amplitude from 0.12 to 0.14 mV (p<0.001) and from 0.17 to 0.21 mV (p<0.001), while QTc interval was shortened from 408 to 398 ms (p<0.001) and from 410 to 401 ms (p<0.001) among hypertensive men and controls, respectively. Cold exposure increased both low (from 390 to 630 ms2 (p<0.001) and 380 to 700 ms2 (p<0.001), respectively) and high frequency heart rate variability (from 90 to 190 ms2 (p<0.001) and 150 to 300 ms2 (p<0.001), respectively), while low-to-high frequency-ratio was reduced. In addition, the frequency of ventricular ectopic beats increased slightly during cold exposure. The cold induced changes were similar between untreated hypertensive men and controls.ConclusionsShort-term cold exposure with moderate facial and mild whole body cooling resulted in prolongation of T-peak to T-end interval and higher T-wave amplitude while QTc interval was shortened. These changes of ventricular repolarization may have resulted from altered cardiac autonomic regulation and were unaffected by untreated hypertension.Trial RegistrationClinicalTrials.gov NCT02007031

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Section: Discussionsupporting

confidence: 90%

Cardiac Repolarization and Autonomic Regulation during Short-Term Cold Exposure in Hypertensive Men: An Experimental Study

et al. 2014

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“…[20,21,22,] in coronary arteries leading to MI. [23,24] In our experiment, we observed highly significantly raised (p<0.001) level of serum triglyceride in the cases when compared with controls. The report of Smith SC et al correlated with our findings.…”

Section: Discussionsupporting

confidence: 53%

A Study of Non-Enzymatic Antioxidant Status in Acute Myocardial Infarction Patients With Metabolic Syndrome Abnormalities

Devi¹,

M²

2016

jemds

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“…Worldwide prevalence of hypertension approaches 1 billion patients, with nearly 74 million in the United States, making it one of the most prevalent clinical disorders. 1 Untreated hypertension is associated with premature mortality and morbidity, including fatal and nonfatal stroke, 2 myocardial infarction, 3,4 coronary heart disease, 5 renal damage, 6,7 and vascular death. 8 The graduated link between blood pressure (BP) control and reduction in cardiovascular morbidity and mortality has been clearly established and accepted in clinical practice.…”

mentioning

confidence: 99%

Blood Pressure Outcomes in Patients Receiving Angiotensin II Receptor Blockers in Primary Care: A Comparative Effectiveness Analysis From Electronic Medical Record Data

Ram

Ramaswamy

Qian

et al. 2011

J of Clinical Hypertension

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The authors examined the comparative effectiveness of 4 angiotensin receptor blockers (ARBs) in patients with hypertension using a large electronic medical record database. Analysis of covariance and logistic multivariate regression models were used to estimate the blood pressure (BP) outcomes of 73,012 patients during 13 months of treatment with olmesartan, losartan, valsartan, and irbesartan. Results were adjusted by baseline BP, starting dose, year, age, sex, race, body mass index, comorbid conditions, and concomitant medications of patients. All ARBs led to sustained reductions in BP, but with significant differences in the magnitude of BP reduction. Raw mean systolic BP ⁄ diastolic BP reductions with losartan, valsartan, irbesartan, and olmesartan were 9.3 ⁄ 4.9 mm Hg, 10.4 ⁄ 5.6 mm Hg, 10.1 ⁄ 5.3 mm Hg, and 12.4 ⁄ 6.8 mm Hg, respectively. Adjusting for all covariates, the overall BP reductions with olmesartan were 1.88 ⁄ 0.86 mm Hg, 1.21 ⁄ 0.52 mm Hg, and 0.89 ⁄ 0.51 mm Hg greater than for losartan, valsartan, and irbesartan, respectively, and mean differences were higher for monotherapy: 2.43 ⁄ 1.16 mm Hg; 2.18 ⁄ 0.93 mm Hg; 1.44 ⁄ 0.91 mm Hg, respectively (all P values <.0001). Adjusted odds ratios of the JNC 7 goal attainment for losartan, valsartan, and irbesartan compared with olmesartan were 0.76, 0.86, and 0.91 (P<.05). Differences were also found in subpopulations: African Americans, diabetics, and obese ⁄ overweight patients but not all of these reached statistical significance.

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Hypertension and Myocardial Ischemia

Cited by 33 publications

References 88 publications

Cardiac Repolarization and Autonomic Regulation during Short-Term Cold Exposure in Hypertensive Men: An Experimental Study

Cardiac Repolarization and Autonomic Regulation during Short-Term Cold Exposure in Hypertensive Men: An Experimental Study

A Study of Non-Enzymatic Antioxidant Status in Acute Myocardial Infarction Patients With Metabolic Syndrome Abnormalities

Blood Pressure Outcomes in Patients Receiving Angiotensin II Receptor Blockers in Primary Care: A Comparative Effectiveness Analysis From Electronic Medical Record Data

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