Longitudinal quantitative assessment of coronary atherosclerosis related to normal systolic blood pressure maintenance in the absence of established cardiovascular disease

Ki Bum Won, Hyung Bok Park, Ran Heo, Byoung Kwon Lee, Fay Y. Lin, Martin Hadamitzky, Yong Jin Kim, Ji Min Sung, Edoardo Conte, Daniele Andreini, Gianluca Pontone, Matthew J. Budoff, Ilan Gottlieb, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Jonathon A. Leipsic, Sang Eun LeeSanghoon Shin, Jung Hyun Choi, Renu Virmani, Habib Samady, Kavitha Chinnaiyan, Daniel S. Berman, Jagat Narula, Jeroen J. Bax, James K. Min, Hyuk Jae Chang

Research output: Contribution to journalArticlepeer-review


Background: Atherosclerosis-related adverse events are commonly observed even in conditions with low cardiovascular (CV) risk. Longitudinal data regarding the association of normal systolic blood pressure maintenance (SBPmaintain) with coronary plaque volume changes (PVC) has been limited in adults without traditional CV disease. Hypothesis: Normal SBPmaintain is important to attenuate coronary atherosclerosis progression in adults without baseline CV disease. Methods: We analyzed 95 adults (56.7 ± 8.5 years; 40.0% men) without baseline CV disease who underwent serial coronary computed tomographic angiography with mean 3.5 years of follow-up. All participants were divided into two groups of normal SBPmaintain (follow-up SBP < 120 mm Hg) and ≥elevated SBPmaintain (follow-up SBP ≥ 120 mm Hg). Annualized PVC was defined as PVC divided by the interscan period. Results: Compared to participants with normal SBPmaintain, those with ≥elevated SBPmaintain had higher annualized total PVC (mm3/year) (0.0 [0.0–2.2] vs. 4.1 [0.0–13.0]; p <.001). Baseline total plaque volume (β =.10) and the levels of SBPmaintain (β =.23) and follow-up high-density lipoprotein cholesterol (β = −0.28) were associated with annualized total PVC (all p <.05). The optimal cutoff of SBPmaintain for predicting plaque progression was 118.5 mm Hg (sensitivity: 78.2%, specificity: 62.5%; area under curve: 0.700; 95% confidence interval [CI]: 0.59–0.81; p <.05). SBPmaintain ≥ 118.5 mm Hg (odds ratio [OR]: 4.03; 95% CI: 1.51–10.75) and baseline total plaque volume (OR: 1.03; 95% CI: 1.01–1.06) independently influenced coronary plaque progression (all p <.05). Conclusion: Normal SBPmaintain is substantial to attenuate coronary atherosclerosis progression in conditions without established CV disease.

Original languageEnglish
Pages (from-to)873-881
Number of pages9
JournalClinical Cardiology
Issue number8
Publication statusPublished - 2022 Aug

Bibliographical note

Funding Information:
This study was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, Republic of Korea, the Ministry of Food and Drug Safety) (Project Number: 202016B02).

Funding Information:
The project was conducted within the framework of a "Multidisciplinary Survey and Monitoring of the Gareja Rock Cut Complex, the Monument of National Value" funded by the National Agency for Cultural Heritage Preservation of Georgia and managed by the Ilia State University, Georgia, together with the Italian Institute for Environmental Protection and Research, Italy, and the support of the University of Milano-Bicocca, Italy. Data used in this work was jointly acquired and, accordingly, belongs to all three institutions.

Publisher Copyright:
© 2022 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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