BACKGROUND:

We evaluated the warranty period
of a normal stress myocardial perfusion single-photon emission computed
tomography (MPS) in hypertensive patients.

METHODS AND RESULTS:

A
total of 471 consecutive hypertensive patients with suspected coronary
artery disease and normal perfusion at stress MPS were followed for a
mean of 76 ± 21 months. Endpoint events were cardiac death or nonfatal
myocardial infarction. With Cox analysis, age (hazard ratio 1.1,
P < .005) and stress test type (hazard ratio 2.7, P < .005) were
independent predictors of events. With parametric Weibull analysis,
patients ≤60 years old undergoing exercise stress test remained at low
risk for the entire length of follow-up, while the highest probability
of events and the major risk acceleration were observed in
those >
 60 years old who underwent pharmacologic stress test. In
patients undergoing exercise test, peak systolic blood pressure (BP;
hazard ratio 1.1, P < .005) emerged as predictor of events, and only
subjects with peak systolic BP < 160 mmHg remained at low risk for
the entire length of follow-up. In contrast, for patients with peak
systolic BP ≥180 mmHg, the time to achieve a cumulative cardiac risk
level of 3% was 18 months.

CONCLUSIONS:

In hypertensive
patients, the warranty period of a normal stress MPS varies according to
stress type and peak systolic BP. A normal stress MPS can be considered
reassuring in subjects ≤60 years old who performed exercise stress test
and a peak systolic BP < 160 mmHg.