Association of Coronary Artery Disease with Abnormal Exercise Electrocardiogram Testing in Hypertensive Patients

Introduction: Coronary artery disease (CAD) is one of the most common causes of death worldwide. Twenty-five percent of people suffering the disease eventually die from sudden death or acute myocardial infarction. This study was established to determine the correlation between CAD and abnormal exercise electrocardiogram (ECG) testing, hypertension, and other associated risk factors. Methods: This cross-sectional study was performed on ۳۸۴ hypertensive patients referred to Isfahan Shariati Hospital Exercise ECG Testing Center in ۲۰۱۱ and ۲۰۱۲. Patients who had irregularities in exercise ECG tests and also had a history of hypertension were selected. Patients with abnormal angiography findings were considered as patients with CAD. Sensitivity and false Positivity of exercise testing compared to angiography were calculated and the data were analyzed using SPSS software. Results: In this study of ۳۸۴ hypertensive patients, angiography was suggestive of CAD in ۳۱۰ patients. Among these patients who underwent exercise testing and angiography in order to diagnose ischemic heart disease or CAD, the most common risk factors were family history (۵۶%), diabetes (۵۴.۲%), dyslipidemia (۴۱.۷%), smoking (۴۰.۹%), obesity (۳۸.۳%), alcohol (۱۳%), addiction (۱۳%), and anxiety (۱۰.۹%). The sensitivity and specificity of ECG exercise testing compared to angiography were calculated as ۷۹% and ۶۴%. Conclusion: According to the results obtained; a detailed history taking and assessing the known risks can assist clinicians to establish the most proper approach to CAD. Also depending on the assessed risk, patients with CAD can benefit from ECG exercise testing much more than strategies using cardiac computed tomography angiography primarily in order to minimize the costs and radiation exposure.