Correlation between Hypertension and SYNTAX Score in Patients with Chest Pain Admitted to Cardiology Department for Coronary Angiography

Background: Hypertension is associated with an increased risk of cardiovascular events, cardiovascular and all-cause mortality. However, the diagnostic ability of hypertension for the presence and severity of CAD (coronary artery disease) has not been elucidated. This study investigates the relationship between hypertension and CAD complexity using the SYNTAX score to determine hypertension’s roles in coronary heart disease progression. Method: This is a prospective study that includes consecutive 410 adult patients at mean age (61 ± 11 years) who are admitted to Cardiology Department and undergo invasive coronary angiography (CAG) where a significant coronary lesion (SCL) is defined as stenosis ≥50% in vessel diameter ≥ 1.5 mm. The SYNTAX scores were calculated using the SYNTAX score algorithm. Results: The mean rank of SYNTAX score was significantly higher among hypertension than non-hypertension (mean rank: 279, 184, p = 0.006) groups. SYNTAX score was positively correlated with age (r: 0.263, p < 0.001) and LDL (correlation coefficient 0.102, p = 0.038) but inversely with HDL (r: 0.107, p = 0.031), in multivariate linear regression age (regression coefficient 0.3, p < 0.001), male (-4.4, p = 0.002), HDL (-6.4, p = 0.002) were significant independent risk factors for SYNTAX score, in ordinal regression model aging (odd ratio: 1.08, p < 0.001), being a male (2.84, p = 0.026), HDL (0.05, p < 0.001), BMI (0.86, p = 0.020) were significantly independent predictor of increase or decrease probability of falling in high syntax score group. Conclusion Hypertension affects the distribution of SYNTAX score among patients with and without hypertension, and the prevalence of significant coronary lesions was more frequent in hypertensive patients. Hypertension was not a predictor of significant or complex coronary artery lesion, but advanced age, being a male, HDL, LDL and BMI are considered as independent risk factors for high SYNTAX score, Subsequently and the complexity of CAD. Therefore, when patients with CAD have these factors, we expect that the Patient’s CAD complexity will be high.