Abstract

Objective Hypertension induces coronary artery disease (CAD) and progression of arterial wall calcification. As coronary calcifications may cause artefacts in 64-slice computed tomography coronary angiography (CTCA), we sought to determine the diagnostic accuracy of CTCA in patients with and without arterial hypertension. Methods Eighty-five consecutive patients with suspected CAD underwent CTCA, calcium-scoring and conventional coronary angiography, and were grouped as hypertensive (28 women, 31 men, mean age 65 +/- 9 years, age range 49-82 years) or normotensive patients (10 women, 16 men, mean age 62 +/- 11 years, age range 39-77 years). On an intention-to-diagnose-basis, no coronary segment was excluded and non-evaluative segments were rated as false positive. Results Per-patient sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the hypertensive group were 91.4, 83.3, 88.9, and 86.9%, while the respective values in the normotensive group were 100, 78.9, 63.6, and 100% (P = 0.42, 0.71, 0.05, and 0.15). In the hypertensive group the prevalence of CAD was 59% and the mean calcium-score was 256; respective values in the normotensive group were 27% and 69, (P < 0.01, and < 0.05 vs. hypertensives). Conclusions Although hypertensives have significantly higher coronary calcifications, sensitivity and specificity are comparably high as in normotensives. The prevalence of CAD is higher in hypertensives and brings about a trend towards a lower NPV and a higher PPV.