Abstract P155: Inadequate Blood Pressure Control in Hypertensive Patients Referred for Cardiac Stress Test
Introduction: Hypertension (HTN) is a powerful risk factor for fatal and nonfatal cardiovascular events. Achieving adequate blood pressure (BP) control can reduce morbidity and mortality from cardiovascular diseases.The current study examined the degree of BP control and incidence of myocardial ischemia in hypertensive patients referred for cardiac stress test.
Methods: We retrospectively analyzed 2,039 consecutive patients with the diagnosis of HTN referred to New York Hospital Medical Center of Queens/Weill Cornell Medical College nuclear cardiology laboratory for stress testing from January 2007 through July 2010. Patients were categorized into well-controlled (<140/90 mmHg), poorly-controlled (140-160/90-100 mmHg), and very poorly-controlled (>160/100 mmHg) groups according to their resting BP measured by an IntelliVue MP70 (Royal Philips Electronics, the Netherlands) non-invasive oscillometric BP monitor. The incidence of ischemia was defined as the presence of at least one reversible perfusion defect on stress/rest single photon emission computed tomography scan
Results: Mean age [±SEM] = 68 ± 13 years, 885 (43.4%) were males. Prevalence of well-controlled HTN was 47.2%, poorly-controlled HTN, 29.5% and very poorly-controlled HTN, 23.3%. Evidence of ischemia was seen in 19.8% and 19.3% of the well-controlled and poorly-controlled group respectively. The very poorly-controlled group had the lowest incidence of ischemia (14.3%) (p < 0.05) compared to the other two groups.
Conclusions: Symptoms mimicking ischemic heart disease in hypertensive patients may be partly explained by poorly controlled BP. Quality of care might be improved by optimally controlling BP in patient with angina symptoms prior to ordering diagnostic testing associated with radiation exposure and cost
Author Disclosures: T.M. Mousa: None. O.A. Akinseye: None. T.C. Kerwin: None.
- © 2015 by American Heart Association, Inc.