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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Blood pressure and vascular calcification
Nicole E Jensky1, Michael H Criqui, Michael C Wright
1Departments of Family and Preventive Medicine, University of California San Diego, La Jolla, Calif 92037, USA. njensky@ucsd.edu
Insights
Pulse pressure and isolated systolic hypertension are strongly linked to calcified atherosclerosis in various blood vessels. These findings suggest isolated systolic hypertension may aid in diagnosing or preventing this condition.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Public Health
Background:
- Atherosclerosis is a significant contributor to cardiovascular disease.
- Calcification extent varies across different vascular beds.
- Blood pressure parameters are established risk factors for cardiovascular events.
Purpose of the Study:
- To investigate the association between blood pressure metrics and calcified atherosclerosis.
- To examine these associations across multiple vascular beds.
- To identify potential clinical indicators for atherosclerosis.
Main Methods:
- Electron beam computed tomography (EBCT) for atherosclerosis detection.
- Mercury sphygmomanometry for blood pressure measurement.
- Multivariable logistic regression analysis adjusting for cardiovascular risk factors.
Main Results:
- Pulse pressure and systolic blood pressure showed significant associations with calcification in most vascular beds.
- These associations were more pronounced in individuals over 60 and in men.
- Isolated systolic hypertension demonstrated stronger associations than general hypertension.
Conclusions:
- Pulse pressure and isolated systolic hypertension are key correlates of calcified atherosclerosis.
- Isolated systolic hypertension may serve as a valuable clinical marker for atherosclerosis.
- Findings highlight the importance of blood pressure management in preventing vascular calcification.
Abstract:
The aim of this study was to determine the associations between the presence and extent of calcified atherosclerosis in multiple vascular beds and systolic blood pressure, diastolic blood pressure, pulse pressure, mean arterial pressure, isolated systolic hypertension, and hypertension. A total of 9510 patients (42.5% women) underwent electron beam computed tomography scanning as part of a routine health maintenance screening. At the same visit, blood pressure was measured with the participant in the seated position using a mercury sphygmomanometer. Mean age was 58+/-11.4 years, and body mass index was 27.1+/-4.5. The prevalences of any calcification in the carotids, coronaries, subclavians, thoracic aorta, abdominal aorta, and iliacs were 31.9%, 57.2%, 31.7%, 37.0%, 54.3%, and 48.8%, respectively. In separate multivariable logistic models containing traditional cardiovascular disease risk factors, pulse pressure and systolic blood pressure were significantly associated with the presence of calcification in all of the vascular beds except the iliacs and subclavians, respectively, with pulse pressure having stronger magnitudes of the associations for most of the vascular beds. Age-stratified analyses indicated that these associations were stronger in those >60 years of age compared with subjects <60 years of age, and sex-stratified analyses demonstrated that men had a greater association compared with women. Also, the magnitudes of the associations for isolated systolic hypertension were, in general, larger than those for hypertension. Pulse pressure and isolated systolic hypertension are robust and important correlates for calcified atherosclerosis in different vascular beds. Isolated systolic hypertension may be clinically relevant in diagnosing or preventing calcified atherosclerosis.
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