TY - JOUR
T1 - Coronary artery calcification predicts long-term mortality in hypertensive adults
AU - Shemesh, Joseph
AU - Motro, Michael
AU - Morag-Koren, Nira
AU - Tenenbaum, Alexander
AU - Apter, Sara
AU - Weiss, Avraham
AU - Ehud, Grossman
PY - 2011/6
Y1 - 2011/6
N2 - 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.
AB - 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.
KW - blood pressure
KW - cardiovascular diseases
KW - coronary calcifications
KW - hypertension
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=79956107311&partnerID=8YFLogxK
U2 - 10.1038/ajh.2011.28
DO - 10.1038/ajh.2011.28
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:79956107311
SN - 0895-7061
VL - 24
SP - 681
EP - 686
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 6
ER -