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Læknablaðið - 15.08.1996, Side 47

Læknablaðið - 15.08.1996, Side 47
LÆKNABLAÐIÐ 1996; 82 593 of those with unrecognised and recognised myocardial infarction was largely the same. One-third of men with unrecognised and 58% of men with recognised myocardial infarction had a history of angina pectoris. Angina pectoris had a greater effect on coronary heart disease mortality in the former group. Silent ST-T changes among men without overt coron- ary heart disease were found to be a marker of latent coronary heart disease and hypertens- ion. These silent ST-T changes were associated with increased mortality. Cardiomegaly was detected in 6.5% of the men in the cohort. It was associated with hypertension in 51% and coronary heart disease in one-third of the ca- ses. The presence of coronary heart disease had marked deleterious effect on the prognosis of those with cardiomegaly and serum cholest- erol concentration, systolic blood pressure and smoking more than 15 cigarettes/day had sign- ificant independent effect on survival. The prevalence of coronary heart disease in Icelandic men is decreasing. The prognosis is determined by a complex interplay between the form of coronary heart disease and the risk factor profile. Unrecognised myocardial in- farction accounts for at least 30% of all myocardial infarction and when associated with angina, the prognosis is severe. Silent ST-T changes among men without known cor- onary heart disease indicate both coronary heart disease and hypertension and signify impaired prognosis. Cardiovascular risk factors maintain their detrimental effects am- ong men with cardiomegaly, indicating that in face of cardiomegaly complacency is not justi- fied in the control of the major risk factors of coronary heart disease.

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