Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients with Coronary Computed Tomographic Angiography

Rine Nakanishi, Lohendran Baskaran, Heidi Gransar, Matthew J. Budoff, Stephan Achenbach, Mouaz Al-Mallah, Filippo Cademartiri, Tracy Q. Callister, Hyuk Jae Chang, Kavitha Chinnaiyan, Benjamin J.W. Chow, Augustin De Lago, Martin Hadamitzky, Joerg Hausleiter, Ricardo Cury, Gudrun Feuchtner, Yong Jin Kim, Jonathon Leipsic, Philipp A. Kaufmann, Erica MaffeiGilbert Raff, Leslee J. Shaw, Todd C. Villines, Allison Dunning, Hugo Marques, Gianluca Pontone, Daniele Andreini, Ronen Rubinshtein, Jeroen Bax, Erica Jones, Niree Hindoyan, Millie Gomez, Fay Y. Lin, James K. Min, Daniel S. Berman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Hypertension is an atherosclerosis factor and is associated with cardiovascular risk. We investigated the relationship between hypertension and the presence, extent, and severity of coronary atherosclerosis in coronary computed tomographic angiography and cardiac events risk. Of 17181 patients enrolled in the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) who underwent =64-detector row coronary computed tomographic angiography, we identifed 14 803 patients without known coronary artery disease. Of these, 1434 hypertensive patients were matched to 1434 patients without hypertension. Major adverse cardiac events risk of hypertension and non-hypertensive patients was evaluated with Cox proportional hazards models. The prognostic associations between hypertension and no-hypertension with increasing degree of coronary stenosis severity (nonobstructive or obstructive =50%) and extent of coronary artery disease (segment involvement score of 1-5, >5) was also assessed. Hypertension patients less commonly had no coronary atherosclerosis and more commonly had nonobstructive and 1-, 2-, and 3-vessel disease than the no-hypertension group. During a mean follow-up of 5.2±1.2 years, 180 patients experienced cardiac events, with 104 (2.0%) occurring in the hypertension group and 76 (1.5%) occurring in the no-hypertension group (hazard ratios, 1.4; 95% confdence intervals, 1.0-1.9). Compared with no-hypertension patients without coronary atherosclerosis, hypertension patients with no coronary atherosclerosis and obstructive coronary disease tended to have higher risk of cardiac events. Similar trends were observed with respect to extent of coronary artery disease. Compared with no-hypertension patients, hypertensive patients have increased presence, extent, and severity of coronary atherosclerosis and tend to have an increase in major adverse cardiac events.

Original languageEnglish
Pages (from-to)293-299
Number of pages7
JournalHypertension
Volume70
Issue number2
DOIs
Publication statusPublished - 2017 Aug 1

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Nakanishi, R., Baskaran, L., Gransar, H., Budoff, M. J., Achenbach, S., Al-Mallah, M., Cademartiri, F., Callister, T. Q., Chang, H. J., Chinnaiyan, K., Chow, B. J. W., De Lago, A., Hadamitzky, M., Hausleiter, J., Cury, R., Feuchtner, G., Kim, Y. J., Leipsic, J., Kaufmann, P. A., ... Berman, D. S. (2017). Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients with Coronary Computed Tomographic Angiography. Hypertension, 70(2), 293-299. https://doi.org/10.1161/HYPERTENSIONAHA.117.09402