Silent Ischemia and Hypertension

Abstract

Hypertension is one of the most serious risk factors for the development of coronary heart disease. Symptomatic and asymptomatic forms of cardiac ischemia exist. About 54% of hypertensive people have silent ischaemia. Changes of the macrovascular level can not be the only underlying cause, as about 50% hypertensive patients with normal coronary angiogram have silent ischemia. There is no relationship between silent ischemia and cardiac hypertrophy. Humoral factors like elevated level of endorfin or neurological factors like elevated threshold of pain take place in the pathophysiology of silent ischemia. Coronary microcirculation defect is considered the main reasone of this phenomenon. It is caused by reduced coronary reserve and endothelium dysfunction. Elementary method of diagnosis silent ischemia is ECG-24h, but the most sensitive is myocardial scintigraphy