“ A STUDY OF CARDIOVASCULAR ABNORMALITY IN HYPERTENSIVE PATIENTS”

Introduction: Hypertension is a common health problem in developed countries and a major risk factor for cardiovascular diseases. Hypertension exhibits an iceberg phenomenon where unknown morbidity exceeds the known morbidity. Genetic and environmental factors are also reported to play a key role in hypertension, 90% of which are better classied as idiopathic. The cause of cardiovascular diseases in the hypertensive patient is blood pressure raised which is present chronically however the cause of elevated BP are different. In adults, 90% of hypertension cases are of essential hypertension .The Remaining 10% of hypertension cases with chronically elevated BP accounts for secondary cause. In hypertensive patient, the risk of cardiovascular disease is increases in men and women. Hypertension and diabetes mellitus are among the most common chronic non-communicable diseases and multifactorial disorders affecting both developed and developing countries and occur at a higher prevalence in the older age group and result from both genetic and environmental etiological factors. The aim of Study of Cardiovascular Abnormality in the Hypertension Patient. Methods: A prospective observational study consists of 95 cases of hypertension is undertaken to study the cardiovascular abnormality by ECG and ECHO. The study will be conducted on patients suffering from hypertension. A written informed consent will be taken from all the patients who are included in study group. All the data of the patients will be recorded on a pretested Performa. Preliminary data like name, age, sex, occupation, residence, date will be recorded. Detailed lipid prole study will be done to nd the correlation in patients with hypertension. All data will be statistically analyzed. Results: Out of 95 cases in the study group, 51 were female cases and 44 were males, 31 cases (7th decade), 40 cases (6th decade), 14 cases (5th decade), 8 cases(4th decade), 2 cases (< 3rd decade). Abnormal ECG changes which constitutes 85 patients, ST elevation was present in 12 patients and T-wave inversion was present in 47 patients, followed by 16 patients were shows left ventricular hypertrophy, 8 cases of cardiomyopathy which shows low voltage complexes. Coronary artery disease was predominant nding in the patients of hypertensive cardiovascular disease which was present in 54 cases out of 95 cases, of which 31 were male patients and 23 were female patients. CAD in hypertension (57%), the incidence of CAD was more in elderly and other abnormalities in hypertensive patients were left ventricular hypertrophy(11.6%), heart failure{due to cardiomyopathy(8.2%) and CAD} and valvular heart disease(4.2%). Conclusion: Cardiovascular abnormality in hypertensive patients encompasses a broad spectrum including coronary artery disease, asymptomatic LVH (either a concentric or an eccentric pattern) and clinical heart failure (with either a preserved or a reduced LVEF) stroke, heart failure, cardiomyopathy, arrhythmia, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis. Elderly age, smoking habits, chronic alcoholism and long standing history of DM have emerged as important risk factor for cardiovascular disease in hypertensive patients.

Diagnosis and management of hypertension in athletes

Arterial hypertension is the most common cardiovascular abnormality reported in the setting of pre-participation screening of large athletic populations. Identification of high blood pressure values during the evaluation of an athlete may raise concern about appropriate management and indications with respect to competitive sport participation, representing a potential cause for exclusion from competitive sports. The diagnostic approach, risk stratification, and clinical management of hypertension in athletes are extensively reviewed and discussed in this chapter.