Assessment of coronary artery disease in hemodialysis patients with delayed systolic blood pressure response after exercise testing

Background: We evaluated usefulness of the postexercise systolic blood pressure (SBP) response for detecting coronary artery disease (CAD) in hemodialysis patients. Methods: A treadmill exercise testing was done, and the SBP response was measured in 44 hemodialysis patients ( 30 men, 14 women; age 41 to 81 years). The postexercise SBP response was defined as the ratio of SBP after 3 minutes of recovery to SBP at peak exercise. Results: The SBP ratio of the 25 subjects with coronary artery stenosis (1.01 +/- 0.13) was significantly greater ( p < 0.01) than 19 subjects without coronary artery stenosis (0.83 +/- 0.10). An SBP ratio greater than 0.92 identified CAD with higher sensitivity, specificity, and accuracy than did the conventional ST-segment depression criterion ( 76 vs. 56%, 90 vs. 53%, and 82 vs. 55%, respectively). Conclusion: Determination of the SBP ratio is a clinically useful, noninvasive method for accurately detecting CAD in hemodialysis patients. Copyright (C) 2005 S. Karger AG, Basel.