Coronary artery calcification predicts long-term mortality in hypertensive adults

Joseph Shemesh*, Michael Motro, Nira Morag-Koren, Alexander Tenenbaum, Sara Apter, Avraham Weiss, Grossman Ehud

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)681-686
Number of pages6
JournalAmerican Journal of Hypertension
Issue number6
StatePublished - Jun 2011


  • blood pressure
  • cardiovascular diseases
  • coronary calcifications
  • hypertension
  • mortality


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