Pattern of Presentation of Coronary Artery Disease in Hypertensive Patients

Background : Hypertension is a major risk factor for coronary artery disease (CAD) and left ventricular hypertrophy (LVH). Hypertensives have a threefold increase in cardiac death (due to either CAD or to cardiac failure). In Sudan hypertension complications were increasing in incidence and prevalence. Evaluating chest pain in hypertensive patients presents challenges because of left ventricular hypertrophy as a cause of chest pain besides CAD. There are limited data on different aspects of hypertension complications. Objectives : To assess the CAD as a cause of chest pain, to see the pattern and severity of CAD and to find the correlation between ECG, ECHO and coronary angiography findings in hypertensive patients Methodology : 135 known hypertensive patients presented with chest pain were assessed through ECG, ECHO and coronary angiography. Results : The participants’ ages ranged between 39 and 90 years, with mean age of 59 years .73.3% of them were found to have CAD. The left anterior descending (LAD) artery was the most involved one. Left main (LM) artery was the least involved. Electrocardiography (ECG) showed that LVH is found in more than 50%of patients with CAD. BMI was >25 in 41.5%. Percutaneous coronary intervention (PCI) was recommended in (31.4%), coronary artery bypass graft (CABG) in(21.6%). 33% and 25% of these consecutively have hypertension for 10 years or more. Conclusion : CAD is the main cause of chest pain in hypertensives. Aging, body mass index, duration and magnitude of hypertension and LVH have strong and frequent association with CAD.