Riffat Sultana, Nuzhat Sultana, Abdul Rashid, Syed Zahid Rasheed, Mansoor Ahmed, Muhammad Ishaq, Abdus Samad


Background: Hypertensive left ventricular hypertrophy (LVH) is associated with increased risk of
arrhythmias and mortality. Objective was to investigate the prevalence of cardiac arrhythmias and
LVH in systemic hypertension. Methods: In all subjects blood pressure was measured,
electrocardiography and echocardiography was done. Holter monitoring and exercise test perform
in certain cases. There were 500 hypertensive patients, 156 (31.2%) men and 344 (69%) women
>30 years of age in the study. Among them 177 (35.4%) were diabetic, 224 (45%) were
dyslipidemia, 188 (37.6%) were smokers, and 14 (3%) had homocysteinemia. Duration of
hypertension (HTN) was ≥2 years). Mean systolic BP (SBP) was 180±20 mm Hg and diastolic BP
(DBP) was 95±12 in male and female patients. Left ventricular mass index (LVMI) was 119.2±30
gm/m2 in male while 103±22 gm/m2 in female patients. Palpitation was seen in 126 (25%) male and
299 (59.8%) female patients. Atrial fibrillation was noted in 108 (21.6%) male and 125 (25%)
female patients, 30 (6%) male and 82 (16.4%) female patients had atrial flutter. Ventricular
tachycardia was noted in 37 (7.4%) male and 59 (11.8%) female patients. Holter monitoring
showed significant premature ventricular contractions (PVC’S) in 109 (21.8%) male and 128
(25.69%) female patients while Holter showed atrial arrhythmias (APC’S) in 89 (17.8%) males and
119 (23.8%) females. Angiography findings diagnosed coronary artery disease in 119 (23.8%) with
CAD male and 225 (45%) without CAD while 47 (9.4%) females presented with CAD and 109
(21.8%) without CAD. Conclusion: A significant association has been demonstrated between
hypertension and arrhythmias. Diastolic dysfunction of the left ventricle, left atrial size and
function, as well as LVH have been suggested as the underlying risk factors for supraventricular,
ventricular arrhythmias and sudden death in hypertensives with LVH.
Keywords: Hypertension, arrhythmias, left ventricular hypertrophy, coronary artery disease

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