Abstract
Hypertension is associated with increased mortality and morbidity1,2. The increase in mortality is partly due to increased sudden cardiac death, which is mostly attributed to malignant cardiac arrhythmias3. Several authors have demonstrated that hypertensive patients have more premature beats than normotensive ones4–9. Ventricular arrhythmias often appear in a paroxysmal-like way, although at other times they may be more or less permanent. They are thought to be caused by a paroxysmal functional factor or “trigger” acting on a suitable structure or “substrate”. The substrate may be a scar, left ventricular hypertrophy, congestive heart failure, inhomogeneity of the myocardium from various causes, drugs, ionic disturbances, etc. On the other hand the paroxysmal factor may be premature beats, ischaemia, heart rate (HR), blood pressure (BP), stress, the autonomic nervous system, time itself, etc. Furthermore, arrhythmias have a tendency for self-perpetuation, as for example in paroxysmal tachycardia, fibrillation or bigeminy.
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References
Kannel WB. Prevalence and natural history of electrocardiographic left ventricular hypertrophy. Am J Med 1983; 75 (Suppl. 3A): 4–11.
Messerli FH, Ketelhut R. Left ventricular hypertrophy: an independent risk factor. J Cardiovasc Pharmacol 1991; 17 (Suppl. 4): S59–67.
Kjekshus J. Arrhythmias and mortality in congestive heart failure. Am J Cardiol 1990; 65: 421–81.
Messerli PH, Glade LB, Elizardi DG, Drenslinski GR, Dunn FG, Frohlich ED. Cardiac rhythm, arterial pressure, and urinary catecholamines in hypertension with and without left ventricular hypertrophy. Am J Cardiol 1981; 47: 480 (abstract).
Aronow WS, Epstein S, Schwartz KS, Koenigsberg M. Correlation of complex arrhythmias detected by ambulatory electrocardiographic monitoring with echocardiographic left ventricular hypertension in persons older than 62 years in a long-term health care facility. Am J Cardiol 1987; 60: 730–2.
Levy D, Anderson KM, Savage DD, Balkus SA, Kannel WB, Castelli WP. Risk of ventricular arrhythmias in left ventricular hypertrophy. The Framingham Study. Am J Cardiol 1987; 60: 560–5.
Levie CJ, Jr, Nunez BD, Garavaglia GE, Messerli FH. Hypertensive concentric left ventricular hypertrophy: when is ventricular ectopic activity increased? South Med J 1988; 81: 696–700.
James MA, Vann Jones J. Ventricular arrhythmias in untreated newly presenting hypertensive patients compared with a matched normal population. J Hypertens 1989; 7: 409–15.
Melina D, Colivicci F, Guerrera G, Santoliquido A. Rhythm disturbances in essential hypertension. J Hum Hypertens 1991; 5: 233.
McLenachan JM, Henderson E, Morris KI, Dargie HJ. Ventricular arrhythmias in patients with hypertensive left ventricular hypertrophy. N Engl J Med 1987; 317: 787–92.
James MA, Jones V. The paradoxical role of left ventricular hypertrophy in wall stress-related arrhythmia. J Hypertens 1992; 10: 167–72.
Sideris DA, Chrysos DN, Maliaras GK, Michalis LK, Moulopoulos SD. Effect of acute hypertension on the cardiac rhythm. Experimental observations. J Electrocardiol 1988; 21: 183–91.
Sideris DA, Kontoyannis DA, Michalis LK, Adraktas A, Moulopoulos SD. Acute changes in blood pressure as a cause of cardiac arrhythmias. Eur Heart J 1987; 8: 45–52.
Sideris DA, Toumanidis ST, Kostis EB, Diakos A, Moulopoulos SD. Arrhythmogenic effect of high blood pressure. Some observations on its mechanism. Cardiovasc Res 1989; 23: 983–92.
Sideris DA, Toumanidis ST, Kostis EB, Spyropoulos G, Moulopoulos SD. Effect of adrenergic blockade of pressure-related ventricular arrhythmias. Acta Cardiol 1991; 46: 215–25.
Sideris DA, Toumanidis ST, Kostis EB, Stagiannis K, Spyropoulos G, Moulopoulos SD. Response of tertiary centers to pressure changes. Is there a mechano-electrical association? Cardiovasc Res 1990; 24: 13–18.
Lab MJ. Contraction-excitation feedback in myocardium: physiological basis and clinical relevance. Circ Res 1982; 50: 757–66.
Levine JH, Guarnieri T, Kadish AH, White RI, Calkins H, Kan JS. Changes in myocardial repolarization in patients undergoing balloon valvuloplasty for congenital pulmonary stenosis: evidence for contraction-excitation feedback in humans. Circulation 1988; 77: 70–7.
Hansen DE, Borganelli M, Stacy GP, Jr, Taylor LK. Dose-dependent inhibition of stretch-induced arrhythmias by gadolinium in isolated canine ventricles. Evidence for a unique mode of antiarrhythmic action. Circ Res 1991; 69: 820–31.
Sideris DA. High blood pressure and ventricular arrhythmias. Eur Heart J 1993; 14: 1548–53.
Lab MJ. Contribution of mechano-electric coupling to ventricular arrhythmias during reduced perfusion. Int J Microcirc Clin Exp 1989; 8: 433–42.
Franz R, Burkhoff D, Yue DT, Sagawa K. Mechanically induced action potential changes and arrhythmia in isolated and in situ canine hearts. Cardiovasc Res 1989; 23: 213–23.
Calkins H, Levine JH, Kass DA. Electrophysiological effect of varied rate and extent of acute in vivo left ventricular load increase. Cardiovasc Res 1991; 25: 637–44.
Sideris DA, Pappas S, Siongas K et al. Effect of pre-and after-load on ventricular arrhythmogenesis. J Electrocardiol 1995; 28: 147–52.
Siongas K, Hadzioannidis V, Goudevenos I et al. The increase in arterial pressure in patients with left ventricular dysfunction: a potential cause of ventricular arrhythmias. Fifth Panhellenie Congress on Hypertension, Athens, 1996:292 (In Greek).
Sideris DA, Toumanidis ST, Anastasiou-Nana M, Zakopoulos N, Kitsiou A, Moulopoulos SD. The circadian profile of extrasystolic arrhythmia. Its relationship to heart rate and blood pressure. Int J Cardiol 1992; 34: 21–31.
Gillis RA, Dionne RA, Standaert F. Suppression by clonidine (St-155) of cardiac arrhythmias induced by digitalis. J Pharmacol Exp Ther 1972; 182: 218–26.
Loaldi A, Pepi M, Agostini PG. 24-hour ambulatory electrocardiographic monitoring. Effect of load manipulation with atenolol, verapamil and nifedipine. Br Heart J 1983; 50: 118–26.
Cleland JGF, Dargie HJ, Hodsman GP et al. Captopril in heart failure: a double blind controlled trial. Br Heart J 1984; 52: 530–5.
Webster MWI, Fitzpatrick A, Nicholls MG, Ikram H, Wells JE. Effect of enalapril on ventricular arrhythmias in congestive heart failure. Am J Cardiol 1985; 56: 566–9.
Papademetriou V, Narayan P, Kokkinos D. Effects of dilitiazem, metoprolol, enalapril and hydrochlorothiazide on frequency of ventricular premature complexes. Am J Cardiol 1994; 73: 242–6.
Mayet J, Chapman N. Left ventricular hypertrophy, arrhythmias, and hypertension. Cardiology 1997; 16: 3–6.
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Sideris, D.A. (1998). Ventricular Arrhythmias in Hypertensives. In: Vardas, P.E. (eds) Cardiac Arrhythmias, Pacing & Electrophysiology. Developments in Cardiovascular Medicine, vol 201. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5254-9_14
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DOI: https://doi.org/10.1007/978-94-011-5254-9_14
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