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TORONTO — A large proportion of patients with hypertension and type 2 diabetes also have silent coronary artery disease, according to myocardial perfusion imaging studies presented at the annual meeting of the Society of Nuclear Medicine.
Christien Côté, M.D., and colleagues carried out a prospective study to identify both the prevalence and severity of silent ischemia in 595 hypertensive patients with and without type 2 diabetes. “We also wanted to establish to what extent type 2 diabetes modified the prevalence and severity of silent CAD in hypertensive patients and we wanted to assess the predictive value of risk factors for silent CAD,” said Dr. Côté, professor of medicine at Laval University, Quebec City.
Study subjects were 45 years of age and older and had either essential hypertension alone (363) or coexisting diabetes (232). None had a history of typical angina, and there were no differences in age, sex, or duration of hypertension between the two groups.
Unlike previous studies, patients were selected for dipyridamole stress testing according to American Diabetes Association guidelines for coronary investigation, observed Dr. Côté.
All patients underwent dipyridamole stress
Investigators also assessed the predictive value of risk factors on the prevalence of silent CAD. In the hypertensive population, they found that only dyspnea was predictive of silent CAD, while both dyspnea and proteinuria were predictive of the same ischemic defect in the hypertensive diabetic population.
Previous studies suggested that the prevalence of silent ischemia in hypertensive diabetic patients varied from about 15% to over 50%. The high prevalence of silent ischemia in hypertensive diabetic patients found in this study is of concern, as asymptomatic patients are unlikely to seek medical attention and, as a result, cardiovascular disease events are less likely to be prevented.
CAD is the leading cause of morbidity and mortality in hypertensive patients, and the coexistence of hypertension and type 2 diabetes further increases this risk, Dr. Côté said.
TORONTO — A large proportion of patients with hypertension and type 2 diabetes also have silent coronary artery disease, according to myocardial perfusion imaging studies presented at the annual meeting of the Society of Nuclear Medicine.
Christien Côté, M.D., and colleagues carried out a prospective study to identify both the prevalence and severity of silent ischemia in 595 hypertensive patients with and without type 2 diabetes. “We also wanted to establish to what extent type 2 diabetes modified the prevalence and severity of silent CAD in hypertensive patients and we wanted to assess the predictive value of risk factors for silent CAD,” said Dr. Côté, professor of medicine at Laval University, Quebec City.
Study subjects were 45 years of age and older and had either essential hypertension alone (363) or coexisting diabetes (232). None had a history of typical angina, and there were no differences in age, sex, or duration of hypertension between the two groups.
Unlike previous studies, patients were selected for dipyridamole stress testing according to American Diabetes Association guidelines for coronary investigation, observed Dr. Côté.
All patients underwent dipyridamole stress
Investigators also assessed the predictive value of risk factors on the prevalence of silent CAD. In the hypertensive population, they found that only dyspnea was predictive of silent CAD, while both dyspnea and proteinuria were predictive of the same ischemic defect in the hypertensive diabetic population.
Previous studies suggested that the prevalence of silent ischemia in hypertensive diabetic patients varied from about 15% to over 50%. The high prevalence of silent ischemia in hypertensive diabetic patients found in this study is of concern, as asymptomatic patients are unlikely to seek medical attention and, as a result, cardiovascular disease events are less likely to be prevented.
CAD is the leading cause of morbidity and mortality in hypertensive patients, and the coexistence of hypertension and type 2 diabetes further increases this risk, Dr. Côté said.
TORONTO — A large proportion of patients with hypertension and type 2 diabetes also have silent coronary artery disease, according to myocardial perfusion imaging studies presented at the annual meeting of the Society of Nuclear Medicine.
Christien Côté, M.D., and colleagues carried out a prospective study to identify both the prevalence and severity of silent ischemia in 595 hypertensive patients with and without type 2 diabetes. “We also wanted to establish to what extent type 2 diabetes modified the prevalence and severity of silent CAD in hypertensive patients and we wanted to assess the predictive value of risk factors for silent CAD,” said Dr. Côté, professor of medicine at Laval University, Quebec City.
Study subjects were 45 years of age and older and had either essential hypertension alone (363) or coexisting diabetes (232). None had a history of typical angina, and there were no differences in age, sex, or duration of hypertension between the two groups.
Unlike previous studies, patients were selected for dipyridamole stress testing according to American Diabetes Association guidelines for coronary investigation, observed Dr. Côté.
All patients underwent dipyridamole stress
Investigators also assessed the predictive value of risk factors on the prevalence of silent CAD. In the hypertensive population, they found that only dyspnea was predictive of silent CAD, while both dyspnea and proteinuria were predictive of the same ischemic defect in the hypertensive diabetic population.
Previous studies suggested that the prevalence of silent ischemia in hypertensive diabetic patients varied from about 15% to over 50%. The high prevalence of silent ischemia in hypertensive diabetic patients found in this study is of concern, as asymptomatic patients are unlikely to seek medical attention and, as a result, cardiovascular disease events are less likely to be prevented.
CAD is the leading cause of morbidity and mortality in hypertensive patients, and the coexistence of hypertension and type 2 diabetes further increases this risk, Dr. Côté said.