Background: Coronary blood flow (CBF) is essential for optimal cardiac performance
and to maintain myocardial viability. There is considerable ambiguity concerning CBF in hypertension.
Objective: To investigate the relationship between CBF and left ventricular (LV) mass in persons
Methods: OvidSP Medline was systematically searched. Eligible articles assessed CBF, and LV
mass in adults with and without hypertension (HTN).
Results: Eleven studies met the entry criteria. All 8 studies reported an increase in CBF (ml/min) for
persons with hypertension (N=212) compared to individuals without hypertension (N=150). Metaanalysis
showed a significant and 2.88 fold higher CBP in hypertension. Six studies adjusted CBF for
LV mass; of which 4 studies reported a reduction in CBF. Meta-analysis showed a significant decrease
in CBF/g LV mass in hypertension. The two studies that did not show a decrease in CBF, used
the argon chromatographic method to measure coronary sinus blood flow suggesting this methodology
may have influenced the results. Using the mean CBF in normotensive group to construct the
expected CBF according to LV mass, reported CBF in HTN was progressively less than expected In
two studies, (N=142), there was a significant inverse correlation between LV mass and CBF/ g LV
mass. Multivariate analysis (three studies) consistently found a highly significant independent relationship
between LV mass and CBF after considering age, sex, heart rate and several other factors.
Conclusion: Hypertension is associated with a reduction in CBF adjusted for LV mass with a highly
significant inverse association between CBF and LV mass. Clinicians should be aware that patients
with hypertension are at greater risk for myocardial ischemia should develop other factors that limit
CBF or myocardial oxygen delivery.