Coronary artery calcification predicts long-term mortality in hypertensive adults.

Abstract

BACKGROUND:

Coronary artery calcification (CAC) predicts mortality in normotensive individuals. We hypothesized that CAC has an impact on long-term mortality in hypertensive patients.

METHODS:

We followed 423 participants of the INSIGHT (International Nifedipine Study Intervention as Goal for Hypertension Therapy) calcification substudy, for the incidence of mortality as a function of CAC. All patients were hypertensive (mean age 64 ± 6 years, 48% male), without coronary artery or peripheral vascular disease, aged >55 years and with at least one more major cardiovascular (CV) risk factor. All underwent a baseline computed tomography (CT) (Dual slice) to determine the calcification score and were followed for a mean period of 14 ± 0.5 years. Mortality and the cause of death were derived from the registry of the Ministry-of-Interior Affairs.

RESULTS:

During the follow-up, 94 patients died; 27 from CV causes, 54 from non-CV causes and 13 of undefined causes. The prevalence of calcification at baseline was 59% (195/329) among the survivors compared to 82% (77/94) in participants who died and 96.7% (26/27) among those who died of CV causes. The incidence of CV death was 14 times higher among those with than those without CAC (9.6% (26/272) vs. 0.7% (1/151); P < 0.01). After adjusting for age, gender, left ventricular hypertrophy, proteinuria, duration of hypertension, and renal function the presence of calcification predicted all cause mortality with a hazard ratio (HR) of 1.8 (95% confidence interval (CI) 1.04-3.07).

CONCLUSIONS:

CAC is associated with long-term mortality in asymptomatic hypertensive adults.

• Authors: Joseph Shemesh, Michael Motro, Nira Morag-Koren, Alexander Tenenbaum, Sara Apter, Avraham Weiss, Ehud Grossman
• Journal: American journal of hypertension (Am J Hypertens) Vol. 24 Issue 6 Pg. 681-6 (Jun 2011) ISSN: 1941-7225 [Electronic] United States
• PMID: 21372801 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Calcinosis (mortality)
• Cardiovascular Diseases (mortality)
• Coronary Artery Disease (mortality)
• Female
• Humans
• Hypertension (mortality)
• Male
• Middle Aged
• Proportional Hazards Models
• Risk Factors