Key result
Myocardial ischemia in hypertension is driven by complex interactions involving endothelial factors, fibrosis, and hemodynamics, with left ventricular hypertrophy providing an optimal template.
Highlights the pathophysiological mechanisms linking hypertension, left ventricular hypertrophy, and myocardial ischemia.
May inform mechanistic research on ischemia in hypertensive LVH; should not yet change clinical practice.
The risks associated with hypertension emerge through a series of complex interactions. Myocardial ischemia is the major contributor to this risk. The mechanisms driving ischemia reflect many of the key factors in hypertension, including endothelial and neurohumoral factors, fibrosis, and hemodynamics. Left ventricular hypertrophy and fibrosis are of fundamental importance and together with hemodynamics provide an optimal template for myocardial ischemia. Understanding the pathophysiology has aided a more rational management approach but challenges remain which, if surmounted, will have an impact on the morbidity and mortality caused by myocardial ischemia in patients with hypertension.
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Stanton et al. (2016) conducted a review in Hypertension, Left Ventricular Hypertrophy, and Myocardial Ischemia. Myocardial ischemia in hypertension is driven by complex interactions involving endothelial factors, fibrosis, and hemodynamics, with left ventricular hypertrophy providing an optimal template.
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