[Diagnostic value of exercise testing in the diagnosis of silent myocardial ischemia in elderly patients with systolic hypertension].
PURPOSE: To evaluate the diagnosis value of exercise testing for silent myocardial ischemia in systolic hypertension of the elderly. METHODS: We compared 110 patients with systolic hypertension (group A) with 104 patients without hypertension (group B). They were submitted to an exercise test according to the Bruce protocol, between January/91 to December/94. Exercise was discontinued if target heart rate was achieved, or fatigue, dyspnea, severe arrhythmia, hypotension or significant ST segment depression > or = 2 mm/0.2 mV developed. RESULTS: Exercise testing showed ischemic ST depression in 22 (20%) of the elderly patients with hypertension systolic and 12 (11.5%) of control elderly patients. The exercise time was shorter in the hypertensives 7.1 +/- 2.9 min vs 8.8 +/- 2.5 min. The ST depression was greater in the hypertensives than the control group: 2.5 +/- 0.8 min vs 1.9 +/- 0.4 min. Also the duration or ischemic ST depression was longer in the hypertensive patients than the control group 5.4 +/- 2.8 min vs 3.4 +/- 1.9 min. CONCLUSION: Elderly hypertensive patients with systolic hypertension have more silent myocardial ischemia than elderly without hypertension. Among the elderly hypertensive patients there was a prevalence of silent ischemia that was 1.7 times higher than in the normotensive elderlies (20% vs 11.5% P < 0.003).