LINKS BETWEEN HYPERTENSION AND MYOCARDIAL-INFARCTION

The mechanisms through which hypertension contributes to the occurrenc e of myocardial infarction should be discussed from two points of view : (1) common risk factors for the two diseases, such as genetic risk, insulin resistance, sympathetic hyperactivity, and vasoactive substanc es such as angiotensin II, and (2) linking factors that are induced by hypertension and contribute to the development of atherosclerosis and myocardial infarction, such as atherosclerosis and left ventricular h ypertrophy. Mechanical stress on blood vessels because of high blood p ressure is an especially important factor in endothelial dysfunction, the progression of atherosclerosis, and plaque rupture. This article c oncentrates on these factors from the perspective of their relationshi p with the renin-angiotensin system, because recent multicenter trials have demonstrated that angiotensin-converting enzyme inhibitors are e ffective for preventing recurrence of myocardial infarction.