Sultana Riffat, Sultana Nuzhat, Rashid Abdul, Rasheed Syed Zahid, Ahmed Mansoor, Ishaq Muhammad, Samad Abdus
Karachi Institute of Heart Diseases, Karachi, Pakistan.
J Ayub Med Coll Abbottabad. 2010 Oct-Dec;22(4):155-8.
Hypertensive left ventricular hypertrophy (LVH) is associated with increased risk of arrhythmias and mortality. Objective was to investigate the prevalence of cardiac arrhythmias and LVH in systemic hypertension.
In all subjects blood pressure was measured, electrocardiography and echocardiography was done. Holter monitoring and exercise test perform in certain cases. There were 500 hypertensive patients, 156 (31.2%) men and 344 (69%) women > 30 years of age in the study. Among them 177 (35.4%) were diabetic, 224 (45%) were dyslipidemia, 188 (37.6%) were smokers, and 14 (3%) had homocysteinemia. Duration of hypertension (HTN) was > or = 2 years). Mean systolic BP (SBP) was 180 +/- 20 mm Hg and diastolic BP (DBP) was 95 +/- 12 in male and female patients. Left ventricular mass index (LVMI) was 119.2 +/- 30 gm/m2 in male while 103 +/- 22 gm/m2 in female patients. Palpitation was seen in 126 (25%) male and 299 (59.8%) female patients. Atrial fibrillation was noted in 108 (21.6%) male and 125 (25%) female patients, 30 (6%) male and 82 (16.4%) female patients had atrial flutter. Ventricular tachycardia was noted in 37 (7.4%) male and 59 (11.8%) female patients. Holter monitoring showed significant premature ventricular contractions (PVC'S) in 109 (21.8%) male and 128 (25.69%) female patients while Holter showed atrial arrhythmias (APC'S) in 89 (17.8%) males and 119 (23.8%) females. Angiography findings diagnosed coronary artery disease in 119 (23.8%) with CAD male and 225 (45%) without CAD while 47 (9.4%) females presented with CAD and 109 (21.8%) without CAD.
A significant association has been demonstrated between hypertension and arrhythmias. Diastolic dysfunction of the left ventricle, left atrial size and function, as well as LVH have been suggested as the underlying risk factors for supraventricular, ventricular arrhythmias and sudden death in hypertensives with LVH.
高血压性左心室肥厚（LVH）与心律失常及死亡风险增加相关。目的是调查系统性高血压患者中心律失常和LVH的患病率。
对所有受试者进行血压测量、心电图检查和超声心动图检查。在某些情况下进行动态心电图监测和运动试验。本研究中有500例高血压患者，年龄大于30岁，其中男性156例（31.2%），女性344例（69%）。其中177例（35.4%）患有糖尿病，224例（45%）患有血脂异常，188例（37.6%）吸烟，14例（3%）患有高同型半胱氨酸血症。高血压病程≥2年。男性和女性患者的平均收缩压（SBP）为180±20 mmHg，舒张压（DBP）为95±12 mmHg。男性患者的左心室质量指数（LVMI）为119.2±30 g/m²，女性患者为103±22 g/m²。126例（25%）男性和299例（59.8%）女性患者有心跳过速症状。108例（21.6%）男性和125例（25%）女性患者有房颤，30例（6%）男性和82例（16.4%）女性患者有房扑。37例（7.4%）男性和59例（11.8%）女性患者有室性心动过速。动态心电图监测显示，109例（21.8%）男性和128例（25.69%）女性患者有显著室性早搏（PVC），而动态心电图显示89例（17.8%）男性和119例（23.8%）女性患者有房性心律失常（APC）。血管造影结果显示，119例（23.8%）患有冠心病的男性和225例（45%）未患冠心病的男性，47例（9.4%）女性患有冠心病，109例（21.8%）女性未患冠心病。
已证实高血压与心律失常之间存在显著关联。左心室舒张功能障碍、左心房大小和功能以及LVH被认为是LVH高血压患者发生室上性、室性心律失常和猝死的潜在危险因素。
