Results:

Htn+ patients were older (65 ± 10 years) compared to htn- (61 ± 12) patients. Prior MI was present in 35% of htn- and 31% of htn+ patients; diabetes was present in 24% of htn+ versus 14% in htn- patients; elevated cholesterol was seen in 51% of htn+ versus 40% of htn- patients, and 32% of htn+ versus 44% of htn- patients were active smokers (all comparisons, p < 0.0001). A resting wall motion abnormality (RWMA) was seen in 47% of htn- and 38% of htn+ patients. SE was normal in 50% of htn+ versus 42% of htn- patients; an ischemic abnormality was noted in 26% of htn+ versus 30% of htn- patients, and an infarct pattern in 24% of htn+ versus 28% of htn- patients (all p < 0.0001). On follow-up, there were a total of 1,587 events (14%) including 924 deaths and 663 MIs. In patients with known CAD, the annual event rate was 7.0% in htn+ and 5.7% in htn- patients (p = 0.02), with corresponding event rates of 3.7% and 2.4% in patients with suspected CAD (p < 0.0001). On multivariable analysis, age, male gender, diabetes, RWMA, and ischemia on SE were independent predictors of events in both hypertensive and normotensive patients. For the cohort of patients on antianginal therapy, annual event rates in htn+ and htn- patients were 10.6% and 9% for those with ischemia and RWMA, 7.7% and 6.5% in those with ischemia only; 4.6% and 5.9% in those with an infarct pattern and 3.6% and 3.1% for normal studies (all p = NS). For patients not on active antianginal therapy, event rates for htn+ and htn- were 11.4% and 6.4% for ischemia with RWMA and 9.0% and 4.3% for ischemia without RWMA; 5.4% and 4.7% for an infarct pattern and 2.0% and 1.5% for normal SE (p = NS for infarct, p ≤ 0.009 for other comparisons).