Abstract
Hypertension is a major risk factor for cardiovascular disease, including coronary atherosclerosis and its clinical manifestations. Non-invasive diagnosis of coronary artery disease in hypertension, however, remains a major clinical challenge. Chest pain frequently occurs in hypertensive patients with and without impairment of coronary blood flow supply. Electrocardiographic abnormalities are also common in these patients, thereby leading to further diagnostic difficulty. On the other hand, international guidelines are rather elusive on the recommended diagnostic pathway for coronary artery disease detection in hypertensive patients.In this article, we review the strengths and limitations of current diagnostic methods used to properly identifying coronary artery disease in hypertensive patients. Furthermore, we analyze the usefulness of adopting preliminary and comprehensive cardiovascular risk stratification, together with the evaluation of markers of organ damage, in order to improve the diagnostic efficacy.Despite the high prevalence of arterial hypertension, we still lack a strategy which would lead to validated and cost-effective clinical decision-making processes in hypertensive patients, which help clinicians to minimize useless, ineffective and expensive diagnostic steps. For this purpose, future guidelines should address the issue of diagnostic strategies for an early identification of hypertensive patients at risk of coronary artery disease. This may facilitate appropriate therapeutic choices to optimize the clinical management of coronary disease in hypertension.
| Original language | English |
|---|---|
| Pages (from-to) | 1226-1235 |
| Number of pages | 10 |
| Journal | American Journal of Hypertension |
| Volume | 25 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2012 |
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Keywords
- arterial hypertension
- blood pressure
- cardiovascular prevention
- cardiovascular risk stratification
- coronary artery disease
- global cardiovascular risk
- hypertension
ASJC Scopus subject areas
- Internal Medicine
Cite this
Non-invasive diagnostic testing for coronary artery disease in the hypertensive patient : Potential advantages of a risk estimation-based algorithm. / Chin, Diana; Battistoni, Allegra; Tocci, Giuliano; Passerini, Jasmine; Parati, Gianfranco; Volpe, Massimo.
In: American Journal of Hypertension, Vol. 25, No. 12, 12.2012, p. 1226-1235.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Non-invasive diagnostic testing for coronary artery disease in the hypertensive patient
T2 - Potential advantages of a risk estimation-based algorithm
AU - Chin, Diana
AU - Battistoni, Allegra
AU - Tocci, Giuliano
AU - Passerini, Jasmine
AU - Parati, Gianfranco
AU - Volpe, Massimo
PY - 2012/12
Y1 - 2012/12
N2 - Hypertension is a major risk factor for cardiovascular disease, including coronary atherosclerosis and its clinical manifestations. Non-invasive diagnosis of coronary artery disease in hypertension, however, remains a major clinical challenge. Chest pain frequently occurs in hypertensive patients with and without impairment of coronary blood flow supply. Electrocardiographic abnormalities are also common in these patients, thereby leading to further diagnostic difficulty. On the other hand, international guidelines are rather elusive on the recommended diagnostic pathway for coronary artery disease detection in hypertensive patients.In this article, we review the strengths and limitations of current diagnostic methods used to properly identifying coronary artery disease in hypertensive patients. Furthermore, we analyze the usefulness of adopting preliminary and comprehensive cardiovascular risk stratification, together with the evaluation of markers of organ damage, in order to improve the diagnostic efficacy.Despite the high prevalence of arterial hypertension, we still lack a strategy which would lead to validated and cost-effective clinical decision-making processes in hypertensive patients, which help clinicians to minimize useless, ineffective and expensive diagnostic steps. For this purpose, future guidelines should address the issue of diagnostic strategies for an early identification of hypertensive patients at risk of coronary artery disease. This may facilitate appropriate therapeutic choices to optimize the clinical management of coronary disease in hypertension.
AB - Hypertension is a major risk factor for cardiovascular disease, including coronary atherosclerosis and its clinical manifestations. Non-invasive diagnosis of coronary artery disease in hypertension, however, remains a major clinical challenge. Chest pain frequently occurs in hypertensive patients with and without impairment of coronary blood flow supply. Electrocardiographic abnormalities are also common in these patients, thereby leading to further diagnostic difficulty. On the other hand, international guidelines are rather elusive on the recommended diagnostic pathway for coronary artery disease detection in hypertensive patients.In this article, we review the strengths and limitations of current diagnostic methods used to properly identifying coronary artery disease in hypertensive patients. Furthermore, we analyze the usefulness of adopting preliminary and comprehensive cardiovascular risk stratification, together with the evaluation of markers of organ damage, in order to improve the diagnostic efficacy.Despite the high prevalence of arterial hypertension, we still lack a strategy which would lead to validated and cost-effective clinical decision-making processes in hypertensive patients, which help clinicians to minimize useless, ineffective and expensive diagnostic steps. For this purpose, future guidelines should address the issue of diagnostic strategies for an early identification of hypertensive patients at risk of coronary artery disease. This may facilitate appropriate therapeutic choices to optimize the clinical management of coronary disease in hypertension.
KW - arterial hypertension
KW - blood pressure
KW - cardiovascular prevention
KW - cardiovascular risk stratification
KW - coronary artery disease
KW - global cardiovascular risk
KW - hypertension
UR - http://www.scopus.com/inward/record.url?scp=84869211962&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84869211962&partnerID=8YFLogxK
U2 - 10.1038/ajh.2012.90
DO - 10.1038/ajh.2012.90
M3 - Article
C2 - 22785407
AN - SCOPUS:84869211962
VL - 25
SP - 1226
EP - 1235
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 12
ER -