Central hemodynamics in patients with coronary heart disease and arterial hypertension

In clinical practice arterial hypertension (АH) and coronary heart disease (CHD) often occur together; therefore they should be considered in the context of cardiovascular continuum. This study addresses central hemodynamics and coronary blood flow in patients with AH and CHD as compared to their isolated forms, as well as the influence of AH on the course of CHD. Subjects of the study included: 125 patients with CHD and AH; 215 patients with isolated CHD; 57 patients with isolated AH; 42 patients without coronary artery involvement formed a control normal group. The left ventriculography and coronary angiography were performed in order to evaluate parameters of central hemodynamics and coronary blood flow in patients of each group. It was shown that the increase of myocardial perfusion improves coronary blood flow in atherosclerotic coronary arteries with moderate stenosis . In hypertensive patients with severe atherosclerotic damage changes in central hemodynamics were accompanied by significant reduction in coronary blood flow, increase of right atrial and end-systolic left ventricular volumes, reduction in left ventricular ejection fraction. Central hemodynamic changes in patients with CHD accompanied by AH depend both on the degree of coronary artery involvement and the presence of AH. The AH, the left ventricular hypertrophy and the increase of ventricular capacity are the main factors, responsible for hemodynamic changes when AH and CHD exist together.