Am J Hypertens. 2021 Mar 18:hpab051. doi: 10.1093/ajh/hpab051. Online ahead of print.
ABSTRACT
BACKGROUND: This study sought to assess the relationship between stage 1 hypertension and subclinical coronary atherosclerosis.
METHODS: A total of 4666 individuals with available coronary computed tomography angiography (CCTA) results from a health checkup were enrolled. The classification of hypertension was adapted from the American College of Cardiology/American Heart Association (ACC/AHA) 2017 guideline. The presence of coronary plaques and its characteristics, coronary artery calcium (CAC) score, and significant stenosis defined as luminal narrowing >50% were assessed.
RESULTS: The mean age was 52.6±7.3 years, and 3311 (71.0%) were men. There was a linear relationship between blood pressure (BP), both systolic BP (SBP) and diastolic BP (DBP), and the presence of coronary plaque. Patients were classified into four groups according to the BP category: normal BP (SBP<120 mm Hg and DBP <80 mm Hg; n=2395; 51.3%), elevated BP (SBP 120-129 mm Hg and DBP <80 mm Hg; n=467; 10.0%), stage 1 hypertension (SBP 130-139 mm Hg or DBP 80-89 mm Hg; n=1139; 24.4%), and stage 2 hypertension (SBP ≥140 mm Hg or DBP ≥90 mm Hg; n=665; 14.2%). Compared to the normal BP group after multivariate adjustment, the stage 1 hypertension group was significantly associated with the presence of atherosclerotic plaque (adjusted odds ratio [95% confidential interval], 1.37 [1.17-1.62]; P<0.001), especially in non-calcified and mixed plaques. The relationship between stage 1 hypertension and stenosis >50% was not statistically significant. Isolated diastolic and isolated systolic stage 1 hypertensions were significantly related to the presence of coronary plaque. The elevated BP group was not associated with any positive CCTA findings.
CONCLUSIONS: Stage 1 hypertension was independently associated with subclinical coronary atherosclerosis.
PMID:33735371 | DOI:10.1093/ajh/hpab051
