Document Detail

Coronary microvascular disease in hypertensives.
MedLine Citation:
PMID:  1541047     Owner:  NLM     Status:  MEDLINE    
Arterial hypertension can badly affect coronary circulation through several mechanisms that are not mutually exclusive, namely, coronary artery disease, left ventricular hypertrophy, and microvascular disease. Theoretical and experimental data suggest that coronary microvascular disease may exist in hypertensives, in whom it can cause both a reduction of coronary flow reserve and a shift to the right of the coronary flow autoregulation curve. To address this issue, we used dipyridamole- echocardiography test, which causes ischemic-like ST segment depression with no detectable changes in left ventricular function in different subsets of patients with microvascular disease (Syndrome X; Hypertrophic cardiomyopathy; acute heart rejection). We found that dipyridamole infusion can cause a similar pattern of response (i.e., echocardiographically silent ST segment depression) in mild-moderate essential hypertensives with normal epicardial coronary arteries, without left ventricular hypertrophy, with increased forearm minimal vascular resistances and with a reduced coronary reserve. This pattern of response identifies hypertensives with higher risk of ventricular arrhythmias, is amplified by acute reduction of diastolic blood pressure and can be reversed, together with the reduction of forearm vascular resistances by chronic antihypertensive treatment. Taken together these findings suggest that microvascular coronary disease can exist in hypertensives with two adverse consequences, consistent with the experimental background: the reduction of coronary flow reserve as well as a shift to the right of the coronary flow autoregulation curve.
A R Lucarini; E Picano; A Salvetti
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical and experimental hypertension. Part A, Theory and practice     Volume:  14     ISSN:  0730-0077     ISO Abbreviation:  Clin Exp Hypertens A     Publication Date:  1992  
Date Detail:
Created Date:  1992-04-09     Completed Date:  1992-04-09     Revised Date:  2008-02-12    
Medline Journal Info:
Nlm Unique ID:  8207790     Medline TA:  Clin Exp Hypertens A     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  55-66     Citation Subset:  IM    
Clinica Medica I, University of Pisa, Italy.
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MeSH Terms
Coronary Circulation
Coronary Disease / diagnosis,  etiology*,  physiopathology
Hypertension / complications*,  physiopathology
Microcirculation / physiopathology
Risk Factors

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