Open AccessIdentifying Which Treated Hypertensive Patients Without Known Coronary Artery Disease Should Be Tested for the Presence of Myocardial Ischemia by Perfusion Imaging
Author(s) -
Lacourcière Yves,
Côté Christian,
Lefebvre Jean,
Poirier Luc,
Dumont Marcel
Publication year - 2007
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1524-6175.2007.07284.x
Subject(s) - medicine , cardiology , coronary artery disease , myocardial perfusion imaging , microalbuminuria , odds ratio , diabetes mellitus , dipyridamole , dyslipidemia , subclinical infection , perfusion , myocardial infarction , confidence interval , ischemia , disease , endocrinology
Stress dipyridamole technetium‐99 m sestamibi single photon emission computed tomographic imaging was used to study myocardial perfusion in 1116 hypertensive patients without known coronary artery disease (CAD). The test confirmed the presence of CAD in 28.9% of patients. As expected, patients with diabetes mellitus (DM) had a significantly higher prevalence of myocardial perfusion abnormalities (35.9% vs 23.9%; odds ratio, 1.79; 95% confidence interval [CI], 1.38–2.33; P <.0001) and high‐risk myocardial imaging (16.4% vs 10.6%; odds ratio, 1.67; 95% CI, 1.18–2.37; P =.004) than those without DM. Odd ratios further increased, again as expected, with dyslipidemia (2.19; 95% CI, 1.54–3.12; P <.0001), peripheral arterial disease (2.61; 95% CI, 1.77–3.85; P <.0001), microalbuminuria (3.03; 95% CI, 1.91–4.82; P <.0001), and abnormal electrocardiographic findings (3.06; 1.68; 95% CI, 2.08–4.48; P <.0001). This large cohort study showed that more than 1 of 4 treated hypertensive patients have subclinical CAD. These study data should be clinically helpful in selecting hypertensive patients who are the most suitable candidates to screen for the presence of CAD.