Author + information
- Amer I. Aladin,
- Mahmoud Al Rifai,
- Shereen H. Rasool,
- Zeina Dardari,
- Joseph Yeboah,
- Khurram Nasir,
- Matthew Budoff,
- Bruce M. Psaty,
- Roger Blumenthal,
- Michael Blaha and
- John W. McEvoy
Background: Since vascular calcification reduces arterial compliance, we tested whether coronary artery calcium (CAC) and aortic root calcium (ARC) are associated with incident hypertension (HTN).
Methods: We studied 3,304 individuals from the MESA study without baseline HTN. Incident HTN was defined by blood pressure (BP, ≥140/90 mmHg), BP medication use, or both. We measured ARC and CAC using cardiac-gated CT. We modeled associations using adjusted discrete-time proportional hazards models. Net reclassification improvement (NRI) was calculated to assess whether CAC reclassified HTN risk when added to the Framingham HTN risk score.
Results: The mean age was 59 ± 10 years; 48% were male and 42% White. There were 1,283 incident HTN cases over a median (IQR) follow-up time of 10.6 (4.5, 11.5) years. In adjusted models, a 1-unit change in ln (CAC+1) was associated with a 12% higher risk of HTN (95% CI; 9-16%). Relative to CAC=0, persons with CAC>400 had a hazard ratio (HR) for HTN of 2.2 (95% CI 1.8-2.9). There was significant interaction between CAC, baseline BP, and ethnicity, such that the association with incident HTN was stronger among persons with baseline BP <120/80 mmHg and not significant among Chinese. Continuous NRI analyses demonstrated that CAC can reclassify risk of incident HTN; NRI= 0.190 (p<0.05). Furthermore, ARC was associated with incident HTN, even after adjustment for CAC (HR 1.4, 95% CI 1.1-1.7).
Conclusions: Persons with coronary and aortic root calcification have higher risk of future HTN.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Toward Precision Medicine in the Treatment of Elevated Blood Pressure
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1186-034
- 2017 American College of Cardiology Foundation