EVALUATION OF CHEST PAIN IN THE MIDDLE AGED BY RATE PRESSURE PRODUCT ANALYSIS

ABSTRACT

Background: Coronary artery disease (CAD) results from imbalance between oxygen supply and demand of the heart. Myocardial oxygen consumption (MVO ) is a good 2 indicator of the response of the coronary circulation to increased myocardial oxygen demand. Direct measurement of MVO is difficult in routine clinical 2 practice but it can be easily calculated by indirect methods like Rate Pressure Product (RPP) analysis. The internal myocardial work performed is represented by RPP and external myocardial work performed is generally expressed as stages of exercise.

Objective of the study: The objective of this study was to study rate pressure product in middle aged with non specific chest pain to isotonic exercise.

Materials and Methods: This is a retrospective cross sectional study carried out in the Department of Medicine, JSS Hospital, Mysore. The study group comprised of 43 patients in the age group of 40-50 years with a history of nonspecific chest pain but normotensive, nondiabetic and with normal resting ECG. Standard Bruce protocol was followed. The patients were divided into two groups – Group A (35 patients with typical angina) and Group B (8 patients with atypical angina). Statistical analysis was done using SPSS version 16.

Results: Mean RPP was decreased in patients with atypical angina (Group B) compared to patients with typical angina (Group A) (p < 0.05).

ABSTRACT

The prevalence of hypertension and its complications are on the rise in the urban population, possibly related to their sedentary lifestyle, stressful job and altered eating habits. Most of the hypertensive population are under diagnosed, untreated, and have inadequate awareness about the disease and associated risk factors. In this study, records of 117 hypertensive patients who underwent treadmill test were analyzed to see the effect of three commonly used antihypertensive drugs and the occurrence of associated risk factors . The patients on Angiotensin converting enzyme inhibitors/Angiotensin receptor blockers (ACEI/ARB), Beta Blockers (BB) and Calcium Channel Blockers (CCB) are expected to have a good control over their BP during treadmill test. But in our study, the rise in mean maximum exercise systolic and diastolic blood pressure of ACEI/ARB groupwere found to be statistically significant when compared to Beta blockers and Calcium channel blockers group.There is also occurrence of significant associated risk factors among the three groups. Hence the combination of the above antihypertensive drugs with Beta Blockers may adequately control exercise induced hypertension .The control of associated risk factors like obesity, Diabetes, Dyslipidemia is also very important to prevent cardiovascular morbidity and mortality.