Association of Stage 1 Hypertension Defined by the ACC/AHA 2017 Guideline With Asymptomatic Coronary Atherosclerosis. (18th March 2021)

• Record Type: Journal Article
• Authors: Yoon, Yong-Hoon; Park, Gyung-Min; Lee, Jong-Young; Lee, Jae-Hwan; Lee, Hanbyul; Roh, Jae-Hyung; Kim, Ju Hyeon; Lee, Pil Hyung; Choe, Jaewon; Kim, Young-Hak; Lee, Seung-Whan
• Is Part Of: American journal of hypertension. Volume 34:Number 8(2021)
• Page Start: 858
• Page End: 866
• Publication Date: 2021-03-18
• Subjects: blood pressure -- coronary atherosclerosis -- coronary computed tomography angiography -- hypertension; Hypertension -- Periodicals; 616.132005
• DOI: 10.1093/ajh/hpab051
• Languages: English
• ISSNs: 0895-7061

Abstract

Abstract: BACKGROUND: This study sought to assess the relationship between stage 1 hypertension and subclinical coronary atherosclerosis. METHODS: A total of 4, 666 individuals with available coronary computed tomography angiography (CCTA) results from a health checkup were enrolled. The classification of hypertension was adapted from the American College of Cardiology/American Heart Association (ACC/AHA) 2017 guideline. The presence of coronary plaques and its characteristics, and other CCTA findings were assessed. RESULTS: There was a linear relationship between blood pressure (BP), both systolic BP (SBP) and diastolic BP (DBP), and the presence of coronary plaque. Patients were classified into 4 groups according to the BP category: normal BP (SBP <120 mm Hg and DBP <80 mm Hg; n = 2, 395; 51.3%), elevated BP (SBP 120–129 mm Hg and DBP <80 mm Hg; n = 467; 10.0%), stage 1 hypertension (SBP 130–139 mm Hg or DBP 80–89 mm Hg; n = 1, 139; 24.4%), and stage 2 hypertension (SBP ≥140 mm Hg or DBP ≥90 mm Hg; n = 665; 14.2%). Compared with the normal BP group after multivariate adjustment, the stage 1 hypertension group was significantly associated with the presence of atherosclerotic plaque (adjusted odds ratio [95% confidential interval], 1.37 [1.17–1.62]; P < 0.001), especially in noncalcified and mixed plaques. The relationship between stage 1 hypertension and stenosis >50% was not statistically significant. Isolated diastolic and isolated systolic stage 1 hypertensions were significantly related to the presence of coronary plaque. The elevated BP group was not associated with any positive CCTA findings. CONCLUSIONS: Stage 1 hypertension was independently associated with subclinical coronary atherosclerosis. Graphical Abstract: