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Relationship of blood pressure measures with coronary artery calcification
Lama S Jamjoum1, Lawrence F Bielak, Stephen T Turner
1Department of Epidemiology, University of Michigan, Ann Arbor, Michigan 48109, USA.
Insights
Blood pressure significantly predicts coronary artery calcification (CAC) in asymptomatic adults, especially at younger ages. Early CAC assessment aids in identifying target organ damage, crucial for cardiovascular disease prevention.
Area of Science:
- Cardiovascular disease research
- Atherosclerosis imaging
- Public health
Background:
- Elevated blood pressure is a key risk factor for coronary artery disease.
- Previous research on blood pressure and coronary artery calcification (CAC) was limited to specific high-risk or young populations.
- CAC is a measure of subclinical atherosclerosis.
Purpose of the Study:
- To investigate the relationship between blood pressure levels and hypertension status with CAC in a general community-based sample.
- To assess the predictive value of blood pressure measures for CAC in asymptomatic adults aged 40 and older.
Main Methods:
- Studied 803 asymptomatic individuals aged 40+ from a community.
- Measured blood pressure and categorized participants into hypertension or normotension groups.
- Assessed CAC using electron beam computed tomography and employed tobit regression models.
Main Results:
- In men, age, smoking, hypertension, LDL-C, and BMI were associated with CAC presence and quantity.
- In women, age, systolic blood pressure, lipid-lowering medication use, and waist-to-hip ratio were associated with CAC.
- Blood pressure's association with CAC was modified by age in both sexes.
Conclusions:
- Blood pressure measures contribute significantly to CAC prediction, particularly in younger individuals.
- CAC quantification can facilitate early detection of target organ disease, aiding preventative strategies.
Background:
Increased blood pressure level is a major risk factor for coronary artery disease. Previous studies of relationships of blood pressure level and hypertension status with coronary artery calcification (CAC), a measure of subclinical atherosclerosis, were restricted to participants who were physician- or self-referred, high risk, selected on hypertension status, or young adults.
Material/Methods:
803 asymptomatic individuals at least age 40 years were studied from a community. Blood pressure level was measured and blood pressure diagnostic category (i.e. hypertension vs. normotension) was determined by considering reported history of physician-diagnosed hypertension, use of antihypertensive medication, and measured blood pressure levels. CAC was measured non-invasively with electron beam computed tomography. Tobit regression models allowed simultaneous modeling of presence and quantity of CAC.
Results:
In men, age, having ever smoked, having hypertension, LDL-C level, and body mass index were significantly and positively associated with presence and quantity of CAC. In women, age, systolic blood pressure level, use of lipid lowering medications, and waist-to-hip ratio were significantly and positively associated with presence and quantity of CAC. Relationships of measures of blood pressure with CAC were modified by age, but no other risk factors, in both sexes.
Conclusions:
Our results indicated that measures of blood pressure make a relatively large contribution to predictions of CAC at younger ages. CAC quantification, especially among younger individuals, may allow for early assessment of the presence and extent of target organ disease.