Arterial hypertension and cardiac arrhythmias

Purpose and data identification One of the main clinical problems of patien ts with arterial hypertension is the presence of arrhythmias, especially if left ventricular hypertrophy exists. Recent results from our group and all data available via Med-Line-search have been analysed, The analysis was fo cused on atrial and ventricular arrhythmias and arrhythmic risk prediction, using noninvasive markers. Results of analysis and conclusion Arterial hypertension is a major cause o f non-rheumatic atrial fibrillation and other supraventricular arrhythmias. The prevalence of ventricular arrhythmias is increased in hypertensive pat ients without left ventricular hypertrophy, compared to normotensives. If l eft ventricular hypertrophy is present, the risk for ventricular tachycardi as is quadrupled. The presence of left ventricular hypertrophy is associate d with an increase in all-cause mortality by a factor of seven in men and n ine in women. In particular, patients with hypertrophy, increased rate of v entricular extrasystoles up to non-sustained ventricular tachycardia and ST -depression in long-term ECG are threatened by sudden cardiac death. At pre sent, it is not possible to safely identify patients with increased risk. R egression of hypertrophy exists along with a decreased rate of ventricular extrasystoles. We hypothesize that by the regression of hypertrophy, the pr evalence of sustained ventricular tachycardia decreases and therefore the p rognosis of those patients can be improved, although controlled studies are not yet available. (C) 2001 Lippincott Williams & Wilkins.