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[Hypertension has no effect on coronary calcifications in asymptomatic patients with hypercholesterolemia]
J L Megnien1, S Jeannin, V Sene
1Centre de médecine préventive cardiovasculaire, INSERM U 28, Hôpital Broussais, Paris.
Insights
Coronary artery calcium scoring in asymptomatic men revealed that age and triglyceride levels, not blood pressure, independently predict atherosclerosis. This highlights the importance of triglycerides in assessing heart disease risk.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Coronary artery calcification is a key indicator of atherosclerosis.
- Non-invasive quantification of coronary artery calcium is crucial for risk assessment.
Purpose of the Study:
- To quantify non-invasively coronary artery calcium in hypercholesterolemic men using ultrafast computed tomography.
- To identify independent predictors of elevated coronary artery calcium scores in asymptomatic individuals.
Main Methods:
- Ultrafast computed tomography was used to measure coronary artery calcium in 111 hypercholesterolemic men.
- Calcium scores were calculated from proximal coronary arteries based on lesion area and peak density.
- Multiple regression analysis was employed to assess associations with age, triglyceride levels, and other risk factors.
Main Results:
- 65% of asymptomatic subjects had a non-zero coronary artery calcium score.
- Elevated calcium scores were independently associated with older age and higher triglyceride levels.
- Blood pressure and other evaluated risk factors did not show independent association with calcium scores.
Conclusions:
- Age and triglyceride levels are significant independent predictors of coronary artery calcification in hypercholesterolemic men.
- Moderate triglyceride elevation may adversely affect large coronary arteries, warranting attention in cardiovascular risk assessment.
- Coronary artery calcium scoring provides valuable information for risk stratification in asymptomatic individuals.
Abstract:
Since calcium in coronary artery walls is considered as an indicator for atherosclerosis, we used ultrafast computed tomography to quantify it non invasively in 111 hypercholesterolemic men. They were selected at worksite by a cholesterol screening program, had total cholesterol (TC) above 5.2 (6.88 +/- 0.82, SD) mmol/l, were aged from 30 to 63 (46 +/- 5 years), had never been treated with lipid lowering or antihypertensive drug, and had no clinical coronary heart disease. Body mass index, blood pressure, smoking and other serum lipids as HDL cholesterol, triglyceride (TG) were evaluated. Calcium score of proximal coronary arteries was calculated on 30 contiguous 3 mm slices from areas and peak density of calcium lesions. The mean score was 30 +/- 69 and ranged from 0 to 440. A zero score was found in 39 subjects who differed from the 72 others only by TG levels (1.44 +/- 0.60 vs 1.85 +/- 0.80; p < 0.05). A multiple regression analysis showed that elevated calcium score was associated independently to age (F = 6.6; p < 0.05) and TG (F = 6; p < 0.05) but not to blood. Thus 65% of these asymptomatic subjects had a non-zero calcium score in coronary arteries. Elevated calcium score was influenced independently by age and triglyceride level, but not by other risk factors, such as blood pressure. This potential adverse effect of moderate triglyceride elevation on large coronary arteries merits attention in the assessment of the risk of coronary heart disease.