ASSOCIATION BETWEEN THE PRESENCE OF CORONARY ARTERY DISEASE AND INTENSIVE LOWERING BLOOD PRESSURE AT THE TIME OF CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY. (April 2021)

• Record Type: Journal Article
• Authors: Suematsu, Yasunori; Tsukihashi, Yohei; Shiga, Yuhei; Miura, Shin-Ichiro
• Is Part Of: Journal of hypertension. Volume 39(2021)e-Supplement 1
• Publication Date: 2021-04
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000746652.79912.14
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract: Objective: Blood pressure (BP) lowering treatment should be an intensive BP control according to JSH2019 guideline. Coronary computed tomography angiography (CCTA) has become more widely available in many general hospitals and enables the accurate non-invasive assessment of coronary artery stenosis for screening. The presence or severity of coronary artery disease (CAD) in patients with intensive BP control at the time of CCTA were compared with those in patients without hypertension (HTN). Design and method: One thousand one hundred consecutive subjects (65 yrs., males 53%) who were clinically suspected of having CAD or who had at least one cardiac risk factor underwent CCTA. The patients were divided into 4 groups: the patients without HTN (non-HTN group), hypertensive patients with intensive BP lowering (Intensive group, < 130/80 mmHg), standard BP lowering (Standard group, 130–139/80–89 mmHg) and uncontrolled BP (Uncontrolled group, 140/90 mmHg<) groups. Results: % CAD in patients with HTN was significantly higher than that in patients without HTN. Interestingly, % CAD in the intensive group was also significantly higher than that in patients without HTN. The intensive group showed older, higher body mass index and the number of significantly stenosed coronary vessels, lower levels of high-density lipoprotein cholesterol in blood, higher rates of dyslipidemia, diabetes, anti-dyslipidemia and anti-diabetic medications. Conclusions: The hypertensive patients with intensive BP lowering showed older, higher rate of CAD and more severe coronary stenosis. Thus, it was suggested that the patients also need more rigorous management of other coronary risk factors, as well as intensive BP lowering, and the patients need to perform CCTA much earlier than we think.