title: Impact of hypertension on the diagnostic accuracy of coronary angiography with computed tomography.
abstract: OBJECTIVE
  Hypertension induces coronary artery disease (CAD) and progression of arterial wall calcification. As coronary calcifications may cause artefacts in 64-slice computed tomography coronary angiography (CTCA), we sought to determine the diagnostic accuracy of CTCA in patients with and without arterial hypertension.
  
  
  METHODS
  Eighty-five consecutive patients with suspected CAD underwent CTCA, calcium-scoring and conventional coronary angiography, and were grouped as hypertensive (28 women, 31 men, mean age 65 +/- 9 years, age range 49-82 years) or normotensive patients (10 women, 16 men, mean age 62 +/- 11 years, age range 39-77 years). On an intention-to-diagnose-basis, no coronary segment was excluded and non-evaluative segments were rated as false positive.
  
  
  RESULTS
  Per-patient sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the hypertensive group were 91.4, 83.3, 88.9, and 86.9%, while the respective values in the normotensive group were 100, 78.9, 63.6, and 100% (P = 0.42, 0.71, 0.05, and 0.15). In the hypertensive group the prevalence of CAD was 59% and the mean calcium-score was 256; respective values in the normotensive group were 27% and 69, (P < 0.01, and < 0.05 vs. hypertensives).
  
  
  CONCLUSIONS
  Although hypertensives have significantly higher coronary calcifications, sensitivity and specificity are comparably high as in normotensives. The prevalence of CAD is higher in hypertensives and brings about a trend towards a lower NPV and a higher PPV.
authors: Cardiovascular Center, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
authors: Lars
authors: L
authors: Husmann
authors: Hans
authors: H
authors: Scheffel
authors: Ines
authors: I
authors: Valenta
authors: Tiziano
authors: T
authors: Schepis
authors: Oliver
authors: O
authors: Gaemperli
authors: Ursina
authors: U
authors: Aepli
authors: Patrick T
authors: PT
authors: Siegrist
authors: Sebastian
authors: S
authors: Leschka
authors: Lotus
authors: L
authors: Desbiolles
authors: Paul
authors: P
authors: Stolzmann
authors: Borut
authors: B
authors: Marincek
authors: Hatem
authors: H
authors: Alkadhi
authors: Philipp A
authors: PA
authors: Kaufmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000175:diagnosis; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*