The purpose of this investigation was to compare the frequencies of normal and abnormal findings from exercise electrocardiography (ECG) and post-exercise echocardiography (ECHO) studies in a series of hypertensive and normotensive individuals who underwent diagnostic testing. Data for the ECG and ECHO variables were obtained simultaneously in association with treadmill exercise studies. Eighty consecutive cases were included in this retrospective study. Records were excluded if patients had: history of myocardial infarction; valvular heart disease; ECG evidence of abnormal Q waves, left ventricular hypertrophy (LVH) with abnormal ST/T wave pattern, or left bundle branch block (LBBB); medications that would alter blood pressure responses or ECG interpretation; technically uninterpretable records; or failure to attain 85% of age-adjusted maximal heart rates in the exercise tests. Subjects were defined as hypertensive (HYP) if any one of the following criteria were met: 1) SBP ≥ 140 mmHg or DBP ≥ 90 mmHg; 2) current use of antihypertensive medications; or 3) history of hypertension. Normotensive subjects (NORM) were defined as absence of the above criteria. In each test, ECG data were taken at peak exercise, and ECHO data were taken immediately post-exercise (~ 45 sec). The ECG response was considered abnormal if the ST shifted ≥ 0.1 mV from baseline at J₆₀ while the ECHO response was considered abnormal when new or worsening of pre-existing wall motion abnormalities was observed. Chi square analysis demonstrated that high blood pressure status Significantly increased the frequency of clinically abnormal findings with ECHO (X²=9.15; p ≤ 0.01). This was not the case for exercise ECG (X²=2.12; p > 0.05). However, there waS no Significant difference in the frequency of normal findings when comparing the two testing methods for both subject groups. These results indicate that resting blood pressure status may influence the rate of occurrence of abnormal vs normal ECG and ECHO findings; these data warrant further evaluation studies with invasive criterion measures of CAD status.