Cardiac prognosis in hypertensive patients. Incidence of sudden death and ventricular arrhythmias.

The cardiac prognosis of hypertensive patients has been able to be precisely determined over the last 20 years as a result of large-scale epidemiologic surveys. The incidence of ischemic heart disease and the importance of left ventricular hypertrophy have been clearly defined in the literature. In contrast, the incidence of sudden death and ventricular arrhythmias has been poorly taken into account, although hypertension increases the risk of sudden death to the same degree as coronary artery disease. The relative risk increases progressively as a function of the quintiles of distribution of blood pressure, reaching a value of 3.2 for the highest quintile. There is also a significant correlation between hypertension and ventricular arrhythmias. Hypertensive subjects with other cardiovascular risk factors such as hypercholesterolemia or smoking and with ventricular extrasystoles, reflecting the presence of silent ischemia, can be considered to be at high risk of cardiac death.