Stress echocardiography for the diagnosis of ischaemia in hypertensives

Exercise treadmill electrocardiography and myocardial perfusion imaging are commonly used in non-invasive tests for the detection of myocardial ischae mia. Unfortunately there are limitations in the assessment of hypertensive patients since these tests frequently provide false-positive results, parti cularly in those subjects with left ventricular hypertrophy, In order to in vestigate the utility of stress echocardiography in hypertensive patients w e assessed 173 subjects undergoing this investigation in our department. Of these, 66 had had coronary angiography within 6 months. Thirty subjects we re hypertensives, 17 with left ventricular hypertrophy, and 36 normotensive s. Patients with a 70% or greater stenosis at coronary angiography were dee med to have sufficient disease to cause myocardial ischaemia, The overall s ensitivity of stress echocardiography for detecting myocardial ischaemia wa s 83% with a specificity of 77%. For the hypertensive group alone the sensi tivity was 93% and specificity 73%, The normotensives had a sensitivity of 76% with a specificity of 80%, In conclusion, in this group of hypertensive s stress echocardiography had a favourable specificity and this was not sig nificantly different from that of normotensive subjects.