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Silent coronary disease seen in many hypertensive diabetics.(Clinical Rounds)
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 Cote, M.D., and colleagues carried out a prospective study to identify both the prevalence and severity of silent ischemia in a total of 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. Cote, who is professor of medicine at the 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. Cote.
All patients underwent dipyridamole stress [.sup.99m]Tc sestamibi single-photon emission CT myocardial perfusion imaging (MPI).
Subsequent images were read by ...
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