Accelerated progression of coronary artery calcification in hypertension but also prehypertension.
J Hypertens
; 34(11): 2233-42, 2016 11.
Article
em En
| MEDLINE
| ID: mdl-27512973
ABSTRACT
OBJECTIVE:
To determine the role of hypertension for coronary artery calcification (CAC) progression.METHODS:
The population-based Heinz Nixdorf Recall study recruited 4814 participants from a German urban population in 2000-2003. CAC was measured using electron-beam computed tomography at baseline and after 5 years. The present analyses refer to 3481 participants with repeat scan (coronary heart disease until 5 years excluded, age at baseline 45-74 years, and 53.1% women). Blood pressure (BP), Framingham risk factors, and antihypertensive medication were recorded at baseline. BP was staged according to Joint National Committee 7 guidelines. Participants under antihypertensive medication were classified as stage 2. CAC at 5 years was predicted from baseline using our dedicated, publicly available algorithm. CAC progression was accordingly classified as slow, expected, or rapid.RESULTS:
Normotension was found in 20.5%, prehypertension in 27.2%, stage 1 hypertension in 15.8%, and stage 2 (ST2) in 36.5%. The frequency of rapid progression increases with BP stage (normotension 16.7% to ST2 21.1%, Pâ=â0.004). Risk factor adjusted relative risk [RR (95% confidence interval), reference normotension] of rapid progression was for prehypertension 1.22 (0.98;1.51), stage 1 1.29 (1.01;1.65), and ST2 1.45 (1.17;1.79). Risk factor adjusted measures of CAC progression per 10âmmHg SBP were already elevated in women with BP below 140/90âmmHg CAC onset, RRâ=â1.22 (1.07;1.40), rapid progression, RRâ=â1.17 (1.05;1.31), 5-year CAC progression, 6.7% (0.5;13.4). In men below 140/90âmmHg, only RR of rapid progression was considerably increased [RRâ=â1.11 (0.96;1.29)].CONCLUSION:
CAC progression, a sign of ongoing target organ damage, is already accelerated in prehypertensive patients, a substantial proportion of our urban population.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Calcinose
/
Pré-Hipertensão
/
Hipertensão
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Hypertens
Ano de publicação:
2016
Tipo de documento:
Article