Long-term prognosis for individuals with hypertension undergoing coronary artery calcium scoring

Valentina Valenti, Bríain Hartaigh, Ran Heo, Joshua Schulman-Marcus, Iksung Cho, Dan K. Kalra, Quynh A. Truong, Ashley E. Giambrone, Heidi Gransar, Tracy Q. Callister, Leslee J. Shaw, Fay Y. Lin, Hyuk Jae Chang, Sebastiano Sciarretta, James K. Min

Research output: Contribution to journalArticle

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Abstract

Background: To examine the performance of coronary artery calcification (CAC) for stratifying long-term risk of death in asymptomatic hypertensive patients. Methods and results: 8905 consecutive asymptomatic individuals without cardiovascular disease or diabeteswho underwent CAC testing(mean age 53.3±10.5, 59.3% male) were followed for amean of 14 years and categorized on the background of hypertension as well as age above or below 60 years (in accordance with the 2014 Guidelines fromthe Joint National Committee 8). The prevalence and severity of CACwere higher for thosewith hypertension versus without hypertension (P b 0.001), and the extent increased proportionally with advancing age (P b 0.001). Following adjustment, the presence of CAC in hypertensivewith respect to normotensive, was associated with worse prognosis for individuals above the age of 60 years (HR 7.74 [95% CI: 5.15-11.63] vs. HR 4.83 [95% CI: 3.18-7.33]) than individuals below the age of 60 (HR 3.18 [95% CI: 2.42-4.19] vs. HR 2.14 [95% CI: 1.61- 2.85]), respectively. A zero CAC score in hypertensive over the age of 60 years was associated with a lower but persisting risk of mortality for (HR 2.48 [95% CI: 1.50-4.08]) that was attenuated non-significant for those below the age of 60 years (P=0.09). In a "low risk" hypertensive population, the presence any CAC was associated with an almost five-fold (HR 4.68 [95% CI: 2.22-9.87]) increased risk of death. Conclusion: The presence and extent of CAC effectively may help the clinicians to further discriminate the longterm risk of mortality among asymptomatic hypertensive individuals, beyond conventional cardiovascular risk and current guidelines.

Original languageEnglish
Pages (from-to)534-540
Number of pages7
JournalInternational Journal of Cardiology
Volume187
Issue number1
DOIs
Publication statusPublished - May 6 2015

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Coronary Vessels
Hypertension
Calcium
Guidelines
Mortality
Cardiovascular Diseases
Population

Keywords

  • All-cause mortality
  • Cardiac computed tomography
  • Coronary artery calcium
  • Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Valenti, V., Hartaigh, B., Heo, R., Schulman-Marcus, J., Cho, I., Kalra, D. K., ... Min, J. K. (2015). Long-term prognosis for individuals with hypertension undergoing coronary artery calcium scoring. International Journal of Cardiology, 187(1), 534-540. https://doi.org/10.1016/j.ijcard.2015.03.060

Long-term prognosis for individuals with hypertension undergoing coronary artery calcium scoring. / Valenti, Valentina; Hartaigh, Bríain; Heo, Ran; Schulman-Marcus, Joshua; Cho, Iksung; Kalra, Dan K.; Truong, Quynh A.; Giambrone, Ashley E.; Gransar, Heidi; Callister, Tracy Q.; Shaw, Leslee J.; Lin, Fay Y.; Chang, Hyuk Jae; Sciarretta, Sebastiano; Min, James K.

In: International Journal of Cardiology, Vol. 187, No. 1, 06.05.2015, p. 534-540.

Research output: Contribution to journalArticle

Valenti, V, Hartaigh, B, Heo, R, Schulman-Marcus, J, Cho, I, Kalra, DK, Truong, QA, Giambrone, AE, Gransar, H, Callister, TQ, Shaw, LJ, Lin, FY, Chang, HJ, Sciarretta, S & Min, JK 2015, 'Long-term prognosis for individuals with hypertension undergoing coronary artery calcium scoring', International Journal of Cardiology, vol. 187, no. 1, pp. 534-540. https://doi.org/10.1016/j.ijcard.2015.03.060
Valenti, Valentina ; Hartaigh, Bríain ; Heo, Ran ; Schulman-Marcus, Joshua ; Cho, Iksung ; Kalra, Dan K. ; Truong, Quynh A. ; Giambrone, Ashley E. ; Gransar, Heidi ; Callister, Tracy Q. ; Shaw, Leslee J. ; Lin, Fay Y. ; Chang, Hyuk Jae ; Sciarretta, Sebastiano ; Min, James K. / Long-term prognosis for individuals with hypertension undergoing coronary artery calcium scoring. In: International Journal of Cardiology. 2015 ; Vol. 187, No. 1. pp. 534-540.
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abstract = "Background: To examine the performance of coronary artery calcification (CAC) for stratifying long-term risk of death in asymptomatic hypertensive patients. Methods and results: 8905 consecutive asymptomatic individuals without cardiovascular disease or diabeteswho underwent CAC testing(mean age 53.3±10.5, 59.3{\%} male) were followed for amean of 14 years and categorized on the background of hypertension as well as age above or below 60 years (in accordance with the 2014 Guidelines fromthe Joint National Committee 8). The prevalence and severity of CACwere higher for thosewith hypertension versus without hypertension (P b 0.001), and the extent increased proportionally with advancing age (P b 0.001). Following adjustment, the presence of CAC in hypertensivewith respect to normotensive, was associated with worse prognosis for individuals above the age of 60 years (HR 7.74 [95{\%} CI: 5.15-11.63] vs. HR 4.83 [95{\%} CI: 3.18-7.33]) than individuals below the age of 60 (HR 3.18 [95{\%} CI: 2.42-4.19] vs. HR 2.14 [95{\%} CI: 1.61- 2.85]), respectively. A zero CAC score in hypertensive over the age of 60 years was associated with a lower but persisting risk of mortality for (HR 2.48 [95{\%} CI: 1.50-4.08]) that was attenuated non-significant for those below the age of 60 years (P=0.09). In a {"}low risk{"} hypertensive population, the presence any CAC was associated with an almost five-fold (HR 4.68 [95{\%} CI: 2.22-9.87]) increased risk of death. Conclusion: The presence and extent of CAC effectively may help the clinicians to further discriminate the longterm risk of mortality among asymptomatic hypertensive individuals, beyond conventional cardiovascular risk and current guidelines.",
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T1 - Long-term prognosis for individuals with hypertension undergoing coronary artery calcium scoring

AU - Valenti, Valentina

AU - Hartaigh, Bríain

AU - Heo, Ran

AU - Schulman-Marcus, Joshua

AU - Cho, Iksung

AU - Kalra, Dan K.

AU - Truong, Quynh A.

AU - Giambrone, Ashley E.

AU - Gransar, Heidi

AU - Callister, Tracy Q.

AU - Shaw, Leslee J.

AU - Lin, Fay Y.

AU - Chang, Hyuk Jae

AU - Sciarretta, Sebastiano

AU - Min, James K.

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N2 - Background: To examine the performance of coronary artery calcification (CAC) for stratifying long-term risk of death in asymptomatic hypertensive patients. Methods and results: 8905 consecutive asymptomatic individuals without cardiovascular disease or diabeteswho underwent CAC testing(mean age 53.3±10.5, 59.3% male) were followed for amean of 14 years and categorized on the background of hypertension as well as age above or below 60 years (in accordance with the 2014 Guidelines fromthe Joint National Committee 8). The prevalence and severity of CACwere higher for thosewith hypertension versus without hypertension (P b 0.001), and the extent increased proportionally with advancing age (P b 0.001). Following adjustment, the presence of CAC in hypertensivewith respect to normotensive, was associated with worse prognosis for individuals above the age of 60 years (HR 7.74 [95% CI: 5.15-11.63] vs. HR 4.83 [95% CI: 3.18-7.33]) than individuals below the age of 60 (HR 3.18 [95% CI: 2.42-4.19] vs. HR 2.14 [95% CI: 1.61- 2.85]), respectively. A zero CAC score in hypertensive over the age of 60 years was associated with a lower but persisting risk of mortality for (HR 2.48 [95% CI: 1.50-4.08]) that was attenuated non-significant for those below the age of 60 years (P=0.09). In a "low risk" hypertensive population, the presence any CAC was associated with an almost five-fold (HR 4.68 [95% CI: 2.22-9.87]) increased risk of death. Conclusion: The presence and extent of CAC effectively may help the clinicians to further discriminate the longterm risk of mortality among asymptomatic hypertensive individuals, beyond conventional cardiovascular risk and current guidelines.

AB - Background: To examine the performance of coronary artery calcification (CAC) for stratifying long-term risk of death in asymptomatic hypertensive patients. Methods and results: 8905 consecutive asymptomatic individuals without cardiovascular disease or diabeteswho underwent CAC testing(mean age 53.3±10.5, 59.3% male) were followed for amean of 14 years and categorized on the background of hypertension as well as age above or below 60 years (in accordance with the 2014 Guidelines fromthe Joint National Committee 8). The prevalence and severity of CACwere higher for thosewith hypertension versus without hypertension (P b 0.001), and the extent increased proportionally with advancing age (P b 0.001). Following adjustment, the presence of CAC in hypertensivewith respect to normotensive, was associated with worse prognosis for individuals above the age of 60 years (HR 7.74 [95% CI: 5.15-11.63] vs. HR 4.83 [95% CI: 3.18-7.33]) than individuals below the age of 60 (HR 3.18 [95% CI: 2.42-4.19] vs. HR 2.14 [95% CI: 1.61- 2.85]), respectively. A zero CAC score in hypertensive over the age of 60 years was associated with a lower but persisting risk of mortality for (HR 2.48 [95% CI: 1.50-4.08]) that was attenuated non-significant for those below the age of 60 years (P=0.09). In a "low risk" hypertensive population, the presence any CAC was associated with an almost five-fold (HR 4.68 [95% CI: 2.22-9.87]) increased risk of death. Conclusion: The presence and extent of CAC effectively may help the clinicians to further discriminate the longterm risk of mortality among asymptomatic hypertensive individuals, beyond conventional cardiovascular risk and current guidelines.

KW - All-cause mortality

KW - Cardiac computed tomography

KW - Coronary artery calcium

KW - Hypertension

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