title: Inadequate Blood Pressure Control in Hypertensive Patients Referred for Cardiac Stress Test.
abstract: The current study examined the degree of blood pressure (BP) control and incidence of myocardial ischemia in hypertensive patients (n=2039) referred for cardiac stress test. Patients were categorized into well-controlled (<140/90 mm Hg), poorly controlled (140-160/90-100 mm Hg), and very poorly controlled (>160/100 mm Hg) groups according to their resting BP. The mean age[±standard error of the mean] of the patients was 68±13 years, and 885 (43.4%) were men. The prevalence of well-controlled hypertension (HTN) was 47.2%, poorly controlled HTN was 29.5%, and very poorly controlled HTN was 23.3%. Evidence of ischemia was seen in 19.8% and 19.3% of the well-controlled and poorly controlled groups, respectively. The very poorly controlled group had the lowest incidence of ischemia (14.3%) (P<.05) compared with the other two groups. Symptoms that mimic 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 patients with angina symptoms prior to ordering diagnostic testing associated with radiation exposure and cost.
authors.affiliation: Queens Heart Institute, Laurelton.
authors.forename: Tarek M
authors.initials: TM
authors.lastname: Mousa
authors.affiliation: Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica.
authors.forename: Oluwaseun A
authors.initials: OA
authors.lastname: Akinseye
authors.affiliation: The New York Hospital Medical Center of Queens, Cornell University Medical College, Flushing.
authors.forename: Todd C
authors.initials: TC
authors.lastname: Kerwin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D015995:Prevalence; D011787:Quality of Health Care / Q000592:standards; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors