Studies in hypertensive heart disease: I. The incidence of coronary atherosclerosis in cases of essential hypertension

Abstract

Abstract An impressive body of evidence points to myocardial anoxemia and ischemia as the probable causes of angina pectoris. Coronary insufficiency is now regarded as the major cause of such ischemia. The importance of aortic insufficiency, thyrotoxicosis, and anemia, as predisposing factors, has been stressed. From an analysis of the anatomic observations in a group of cases of angina pectoris associated with hypertension and a group without hypertension, it appears that other factors, not yet emphasized in the literature, play a role in the production of the anginal syndrome in cases of essential hypertension. The significance of these factors is discussed in the present communication. The anatomic basis of angina pectoris, as disclosed by the very exact injection-dissection techique of Schlesinger, 1 has been described else-where. In the present study, routine autopsy protocols were used; admittedly, this method yields data which are less reliable than those made available by the above-mentioned technique. They have the advantage, however, of making possible a study of a much larger series of cases.