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[Positive exercise test in hypertensive patients correlated with coronary angiography]
J Rosado1, C de los Santos, P Iturralde
1Departamento de Electrocardiografía y Electrofisiología, Instituto Nacional de Cardiología, Ignacio Chávez, México, D.F.
Insights
Hypertension and exercise stress tests reveal significant coronary artery disease in most patients. Over 70% of hypertensive individuals with positive stress tests showed obstructive coronary lesions, indicating a high prevalence of heart disease.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Hypertension is a major risk factor for coronary artery disease (CAD).
- Exercise stress testing is a common tool for evaluating patients with suspected CAD.
- The correlation between exercise test results and angiographic findings in hypertensive patients requires further elucidation.
Purpose of the Study:
- To assess the state of coronary arteries in hypertensive patients who had a positive exercise stress test.
- To determine the prevalence and severity of coronary artery lesions in this patient group.
Main Methods:
- Selected 82 hypertensive patients (50 male, 32 female; mean age 56.9 years) with positive exercise tests.
- Performed coronary angiography to evaluate coronary artery status.
- Analyzed exercise test parameters and their correlation with angiographic findings.
Main Results:
- Coronary angiography revealed normal arteries in 25 patients.
- 13 patients had non-significant narrowings (<50%).
- 44 patients (54% of the cohort) had significant coronary artery lesions (>50%).
- Systolic hypertension or a flat response during exercise was more frequent in patients with advanced coronary lesions (66% and 75% predicted positive value).
- Exercise test parameters were not statistically significant on their own.
Conclusions:
- A high proportion (70%) of hypertensive patients with positive exercise tests have obstructive coronary artery lesions.
- Specific exercise test responses, like systolic hypertension or flat response, may indicate a higher likelihood of significant coronary obstructions.
- Coronary angiography remains crucial for definitive diagnosis in hypertensive patients with positive stress tests.
Abstract:
With the purpose of evaluate the state of the coronary arteries in hypertensive patients with positive exercise test, 82 patients were selected, 50 male and 32 female with mean age of 56.9 +/- 13.2 years. Angiography was normal in 25 patients thirteen patients had a single coronary arteries narrow of less than 50% and 44 cases with significant coronary arteries lesions of more than 50%. The parameters obtained in the exercise test are not significant for statistic purposes. Systolic hypertension or flat response was more frequent in the group with advanced coronary lesions with a predicted positive value in coronary obstructions of 66 and 75%. We conclude that 70% of hypertensive patients have obstructive coronary lesions of some degree.