Asymptomatic ST-segment depression in patients with primary hypertension Introduction: Asymptomatic ST-segment depression (ASTD) is a transient event and is mainly detectably by means of 24 h ambulatory ECG recording. It was first reported in patients with coronary artery disease. Subsequently, it was observed in essentially hypertensive patients without symptoms of coronary artery disease. The aim of the study: was to investigate ASTD in essentially hypertensive patients without symptomatic

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... onary artery disease in relation to different clinical parameters (including ambulatory blood pressure monitoring, 24 h ECG recording and echocardiography). Material and methods: The study included 77 men with mild to moderate essential hypertension without symptomatic coronary artery disease. Ambulatory blood pressure monitoring, 24-hour ambulatory ECG, echocardiography and stress test were done in all subjects. ASTD was defined as ST-segment depression of 0.1 mV or more (horizontal or downsloping) at 60 ms after the J point that lasts for more than 60 s and occurs not earlier than 60 s after previous ST-segment depression. Amount, duration, maximal value and diurnal distribution of ASTD were analysed. Results: ASTD was found in 14 subjects (18% of the studied group). Subjects with ASTD had higher night systolic blood pressure levels (130 ± 14 vs. 124 ± 12 mm Hg; p = 0.093), higher night mean arterial pressure levels (98 ± 12 vs. 92 ± 10 mm Hg; p = 0.08) and higher 24 h systolic blood pressure load (58% ± 29% vs. 44% ± 27%; p = 0.097) as compared to subjects without ASTD. There were non-significantly more non-dippers among subjects with ASTD (57%; 8 subjects) as compared to subjects without ASTD (40%; 25 subjects). There were not any significant differences between subjects with or without ASTD in frequency of left ventricular hypertrophy and in types of left ventricular geometry. Conclusions: Asymptomatic ST-segment depression is a rather common event among patients with mild and moderate arterial hypertension. In those patients asymptomatic ST--segment depression does not correlate with left ventricular hypertrophy nor with the types of Adres do korespondencji: Dr med. Elżbieta Florczak Klinika Nadciśnienia Tętniczego IK ul. Alpejska 42, 04-628 Warszawa Nadesłano: 26. 06. 2002 r. Przyjęto do druku: 12.07.2002 r. Badania zrealizowano w latach 1997-2001 w ramach pracy statutowej Instytutu Kardiologii.