ABSTRACT
Normal ECG does not exclude significant coronary artery disease or left ventricular hypertrophy. Silent ischemia is common in hypertensive patients. Nowadays there is increase in the prevalence of essential hypertension in young adults. Is to test the significance of exercise ECG in detection of CAD, and its prevalence in young hypertensive patients. This study included 100 patients with age range between 16-35 year. A control group of 20 healthy adult volunteers of the same age range. All patients were subjected to thorough History taking, Clinical assessment, Laboratory investigations [FBS, Lipid profile], Baseline ECG, Echocardiographic study, Exercise stress testing. The resting systolic blood pressure, mean maximum systolic blood pressure and The recovery heart rate were significantly correlated with LV mass in hypertensive patients. There was a significant dyslipidemia and impaired diastolic function in hypertensive patients, and this dyslipidemia correlated with LV mass. LV mass, dyslipidemia, and diastolic dysfunction were the most determine, related to abnormal exercise response in hypertensive patients. Patients with ST-segment depression showed a sign of increased LV mass, increased recovery heart rate and dyslipidemia