Isolated t-wave abnormalities and evaluation of left ventricular wall motion after nifedipine for severe hypertension

Robert A. Phillips, Martin E. Goldman, Maria Ardeljan, Howard B. Eison, Seiichi Shimabukuro, Lawrence R. Krakoff

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Rapid reduction of blood pressure by vasodilators in severe hypertensives has been associated with T- wave inversion. The significance of these changes in the absence of chest pain or other manifestations of ischemia is not known. To determine if these T- wave inversions are due to myocardial ischemia, we obtained electrocardiograms and left ventricular wall motion studies (2-D echocardiography) before and 1 h after rapid blood pressure reduction with nifedipine in 23 severe hypertensives. One hour after 10 mg nifedipine blood pressure was markedly reduced from 189 ± 6/117 ± 3 (mean ± SE) to 151 ± 5/91 ± 3 mm Hg (P <.001). New T-wave inversions developed in 6 of 23 (26%) subjects, but blinded evaluation of 2-D echocardiograms revealed no new wall motion abnormalities. Wall motion score, which at pretreatment was abnormal in 11 of 23 pa­tients, improved significantly after nifedipine from 1.4 ± 0.1 to 1.2 ± 0.1 (P <.05). Therefore, rapid and marked reduction of blood pressure with nifedipine is accompanied by a high incidence of asymptomatic T-wave inversions which are not accompanied by left ventricular wall motion abnormalities, suggest­ing that significant myocardial ischemia did not occur. Am J Hypertens 1991;4:432-437.

Original languageEnglish (US)
Pages (from-to)432-437
Number of pages6
JournalAmerican Journal of Hypertension
Volume4
Issue number5
DOIs
StatePublished - Jan 1 1991

Keywords

  • Hypertension
  • Left ventric­ular wall motion
  • Myocardial ischemia
  • Nifedipine

ASJC Scopus subject areas

  • Internal Medicine

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