Coronary artery disease among hypertensive patients undergoing coronary computed tomography angiography

OBJECTIVE: Coronary artery disease (CAD) is a leading cause of morbidity and mortality in hypertensive patients. However, the true prevalence of CAD in hypertensive patients is unknown. The aim of our study was to investigate the relationship between CAD and hypertension in patients undergoing coronary computed tomography (CT) angiography (CCTA). METHODS: Three hundred and fifty-two consecutive patients were referred for cardiac evaluation, 125 with hypertension and 227 without hypertension. There were no statistical differences between the groups in several parameters: age, sex, and CAD risk factors. CAD was defined as coronary atherosclerosis, with obstructive or nonobstructive lesions. CCTA was performed, and findings were compared between patients with hypertension and those without. RESULTS: CAD was present in 103 (82%) hypertensive and 164 (72%) normotensive patients (P < 0.0001). Obstructive CAD was twice as common in hypertensive patients, and they had more plaques per coronary segment than did normotensive patients. Patients with hypertension duration of at least 10 years had more segments with CAD. CONCLUSION: CAD is more prevalent and severe in hypertensive patients than in normotensive patients. CAD severity increases with hypertension duration. CCTA may help to identify high-risk patients needing further evaluation for subclinical ischemia.