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Prevalence of coronary calcification in relation to age, gender and risk factor profile in the insight population
1Cardiac Rehabilitation Institute, Sheba Medical Center, Tel-Aviv University Sackler School of Medicine, Tel-Hashomer, Israel.
Insights
This study investigates if nifedipine or diuretics can slow coronary artery calcification in high-risk hypertensive patients. It also assesses their impact on left ventricular changes.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Vascular Biology
Background:
- Calcium plays a critical role in vascular wall functions, including endothelial permeability, lipoprotein and monocyte penetration, platelet activation, smooth muscle proliferation, and fibrous tissue synthesis.
- Calcium channel blockers have shown promise in retarding atherosclerosis development in animal models.
- Coronary artery calcification is a key indicator of atherosclerosis, detectable non-invasively.
Purpose of the Study:
- To compare the efficacy of nifedipine versus diuretics in arresting or slowing coronary artery calcification progression in high-risk hypertensive patients.
- To evaluate the effects of nifedipine and diuretics on left ventricular hypertrophy, mass, and function.
Main Methods:
- A comparative study involving hypertensive patients at high risk for coronary calcification.
- Utilizing double helix computerized tomography for non-invasive assessment of coronary artery calcification.
- Monitoring left ventricular parameters including hypertrophy, mass, and function.
Main Results:
- The study aims to determine if nifedipine or diuretics impact the progression of coronary calcification.
- It will also assess the differential effects of these medications on cardiac remodeling and function.
Conclusions:
- The findings will elucidate the role of nifedipine and diuretics in managing coronary artery calcification and associated cardiovascular risks.
- This research could inform treatment strategies for hypertensive patients prone to atherosclerosis.
Abstract:
Calcium controls numerous events within the vessel wall. Permeability of the endothelium is calcium dependent. Calcium is also essential for penetration of low-density lipoprotein particles through the endothelium as well as the monocytes that travel through the subendothelial space. Other calcium-dependent processes include platelet activation and adhesion, vascular smooth muscle proliferation and migration, and synthesis of fibrous connective tissue in the subendothelial space. Current evidence indicates that calcium channel blockers retard the development of atherosclerosis in monkeys and rabbits. Human trials have evaluated sequential coronary angiograms in patients undergoing coronary angiography for symptomatic coronary artery disease. Double helix computerised tomography is a non-invasive technique that can detect, measure and compare calcification in the coronary arteries. Our objectives are to determine whether the use of nifedipine vs diuretics in hypertensive patients at high risk of coronary calcification will arrest or slow the progression of calcification in the coronary arteries, and to assess the effect of the two drugs on left ventricular hypertrophy, and left ventricular mass as well as on changes in left ventricular function.