ISOLATED SYSTOLIC HYPERTENSION (ISH) AMONG ELDERLY EGYPTIANS, IS THERE A HIDDEN RISK?
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Isolated systolic hypertension (ISH) represents an important public health problem in the nineties because of its high prevalence in the elderly as well as the recent reports about its probable implication as a risk factor for ischaemic heart disease. The aim of this study is to evaluate the clinical significance of 1511 as arisk factor for coronary heart disease (CHD) among elderly Egyptians. The current study included 20 males aged between 50-70 years with a mean age of 53.3 ± 5.8 years. having ISH and 20 normal healthy normotensiue males with a mean age of 57.7 ± 5.9 years as a control group Patients with 151-1 had a mean systolic blood pressure of 164.8 ± 4.1 mm Hg and a mean diastolic blood pressure of 82.8 ± 7.2 mm Hg.The control subjects had a mean systolic blood pressure of 122.5 ± 10.1 mm Hg and a mean diastolic blood pressure of 76 ± 6.8 mm Hg. Studied cases had other risk factors for CHD (Diabetes mellitus, hperlipidemia ...etc) been excluded in addition to secondary causes of 1511 as aortic regurge and hyperthyroidism. After careful history taking and routine Lab testing all studied cases were tested by resting standard 12 leads ECG. exercise ECG and 24 hours Hotter monitoring. The results of the study showed that CHD incidence was higher in patients with ISH as compared to the control group. Sixty percent of15H patients ( 12 cases) had their exercise test and 40% of them (8 cases) had their Hotter monitor test for CHD positive. Five cases (25%) of patients with 18H had both tests positive for coronary heart disease while only one case of the control group (5%) had positive results in both tests. The difference is highly significant. Seven cases with ISH(35%) had positive treadmill test and nega-. Live Hotter monitor test while three cases ( 15%) had positive hotter test and negative treadmill test. In ISH patients a positive correlation was found between the level of systolic pressure and each of the degree and number of ST segment changes as detected by treadmill test and Hotter monitor test. We might conclude that ISH among elderly Egyptians shouldnot be neglected as in the past as ISH patients might have an underlying silent CHD endangering their lives. The relation between ISH and CHD needs further detailed studies particularly considering the influence of treating ISH on the outcome of CHD. Exercise ECG and Hotter monitor test represent easy, non-invasive investigations for the detection of silent myocardial ischaemia among patients with ISH.