[Arterial hypertension and coronary heart disease: clinical and functional aspects]

The subjects of the study were 196 men with verified coronary heart disease (CHD). The subjects were divided into 4 groups: 1) patients without arterial hypertension (AH); 2) patients with mild AH, 3) patients with moderate AH, 4) patients with severe AH (SAH). All the patients were tested by means of veloergometry. The study found that the presence and severity of AH affected functional condition of cardiovascular system and clinical manifestations in patients with CHD. The appearance and aggravation of AH in CHD patients: 1) diminished clinical manifestations (angina), and elevated frequency of ECG signs of myocardial ischemia; there was significant growth of the proportion of patients with painless myocardial ischemia and ventricular arrhythmias associated with physical activity; 2) while causing moderate decrease of physical tolerance, substantially decreased the economy of cardiovascular system functioning, associated mostly with 'pressure overload"; pressor reaction effectiveness lowered; 3) worsened disturbances of recovery period, which manifested in prolongation of the time necessary for systolic pressure to return to initial level. These peculiarities were most prominent in patients with CHD and SAH, which allows considering this combination to be a new condition, requiring new approaches to evaluation of its clinical course and therapy.