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CAC, extra-coronary calcium increase risk for hypertension
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Patients with coronary artery calcium and extra-coronary calcium had an increased risk for incident hypertension, according to a study published in The American Journal of Cardiology.
Amer I. Aladin, MD, FACP, FAAFP, of the department of cardiology at Wake Forest University Baptist Health in Winston-Salem, North Carolina, and the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins School of Medicine, and colleagues analyzed data from 3,304 patients (mean age, 59 years; 48% men) from the MESA study who were free from hypertension and CVD at baseline.
Patients were followed up periodically for a median of 10.6 years, when CAC, aortic valve calcium, systolic and diastolic BP, demographic characteristics and CV risk factors were measured. Net classification improvement was used to assess the ability of CAC to reclassify the risk for incident hypertension when added to the Framingham risk score.
During follow-up, incident hypertension was diagnosed in 1,283 patients. The risk for incident hypertension increased by 12% (95% CI, 9-16) with each 1-unit increase in log-normal CAC score+1.
Patients who had a CAC score greater than 400 had an increased risk for incident hypertension (HR = 2.2; 95% CI, 1.8-2.9) compared with those with a CAC score of 0. CAC scores were not linked to sex (P = .19), age (P = .43) or baseline BP status (P = .09).
CAC reclassified the risk for incident hypertension when added to the Framingham risk score (net reclassification improvement = 0.188; 95% CI, 0.104-0.263). After adjusting for CAC, all measurements of extra-coronary calcium were linked to incident hypertension, with HRs ranging from 1.36 to 1.38.
“There are several potential explanations for the relation between CAC and incident hypertension,” Aladin and colleagues wrote. “Subjects with elevated CAC typically carry a higher burden of cardiac risk factors, which are also associated with development of hypertension. Thus, the shared risk factors between CAC and hypertension may link both conditions (eg, diabetes mellitus, low- or high-density lipoprotein cholesterol and obesity). However, in our analysis, the association between CAC and hypertension persisted in models accounting for such variables.” – by Darlene Dobkowski
Disclosure s : Aladin reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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