Coronary angiographic patterns in hypertensive compared with normotensive patients

Area of Science:

• Cardiology
• Hypertension Research
• Vascular Disease

Background:

• Coronary artery disease (CAD) is a leading cause of mortality worldwide.
• Hypertension is a major risk factor for cardiovascular diseases.
• The impact of untreated primary hypertension on the natural history of CAD requires further elucidation.

Purpose of the Study:

• To investigate the influence of untreated primary hypertension on the prevalence and progression of coronary artery narrowing.
• To compare the extent of coronary artery disease in hypertensive versus normotensive patients presenting with effort angina.

Main Methods:

• Coronary angiography was performed on 640 patients (320 hypertensive, 320 normotensive) with classic effort angina and positive exercise tests.
• Patients were stratified by age (decades) and disease severity (single-, double-, triple-vessel disease).
• Demographic and clinical data, including serum lipids, glucose, and smoking habits, were compared between groups.

Main Results:

• Prevalence of single- and double-vessel disease was similar in hypertensive and normotensive patients across decades.
• Triple-vessel disease prevalence increased with age in both groups, peaking in the seventh decade.
• Hypertensive patients in the sixth and seventh decades showed significantly higher rates of triple-vessel disease (40% and 50%) compared to normotensive individuals (25% and 31%).
• No significant difference in left main coronary artery involvement was observed.

Conclusions:

• Untreated primary hypertension does not accelerate the initial development of significant coronary narrowing or multi-vessel involvement.
• Hypertension appears to aggravate the age-related progression of coronary artery disease, particularly triple-vessel disease, starting from the sixth decade.
• The findings suggest a link between elevated blood pressure itself and the accelerated progression of CAD in older hypertensive individuals.