Hennersdorf M G, Strauer B E
Department of Cardiology, Pneumology and Angiology, Medical Clinic and Policlinic B, Heinrich-Heine-University, Duesseldorf, Germany.
J Hypertens. 2001 Feb;19(2):167-77. doi: 10.1097/00004872-200102000-00002.
One of the main clinical problems of patients with arterial hypertension is the presence of arrhythmias, especially if left ventricular hypertrophy exists. Recent results from our group and all data available via Med-Line-search have been analysed. The analysis was focused on atrial and ventricular arrhythmias and arrhythmic risk prediction, using non-invasive markers. RESULTS OF ANALYSIS AND CONCLUSION: Arterial hypertension is a major cause of non-rheumatic atrial fibrillation and other supraventricular arrhythmias. The prevalence of ventricular arrhythmias is increased in hypertensive patients without left ventricular hypertrophy, compared to normotensives. If left ventricular hypertrophy is present, the risk for ventricular tachycardias is quadrupled. The presence of left ventricular hypertrophy is associated with an increase in all-cause mortality by a factor of seven in men and nine in women. In particular, patients with hypertrophy, increased rate of ventricular extrasystoles up to non-sustained ventricular tachycardia and ST-depression in long-term ECG are threatened by sudden cardiac death. At present, it is not possible to safely identify patients with increased risk. Regression of hypertrophy exists along with a decreased rate of ventricular extrasystoles. We hypothesize that by the regression of hypertrophy, the prevalence of sustained ventricular tachycardia decreases and therefore the prognosis of those patients can be improved, although controlled studies are not yet available.
动脉高血压患者的主要临床问题之一是心律失常的存在，尤其是存在左心室肥厚时。我们团队的最新研究结果以及通过医学在线搜索获得的所有可用数据均已进行分析。分析聚焦于使用非侵入性标志物的房性和室性心律失常以及心律失常风险预测。
动脉高血压是非风湿性心房颤动和其他室上性心律失常的主要原因。与血压正常者相比，无左心室肥厚的高血压患者室性心律失常的患病率增加。如果存在左心室肥厚，室性心动过速的风险会增加四倍。左心室肥厚的存在使男性全因死亡率增加7倍，女性增加9倍。特别是，伴有肥厚、室性早搏发生率增加直至非持续性室性心动过速以及长期心电图出现ST段压低的患者面临心源性猝死的威胁。目前，尚无法安全地识别风险增加的患者。随着肥厚的消退，室性早搏的发生率会降低。我们推测，通过肥厚的消退，持续性室性心动过速的患病率会降低，因此这些患者的预后可以得到改善，尽管目前尚无对照研究。
