BACKGROUND:Increased blood pressure level is a major risk factor for coronary artery disease. Previous studies of relationships of blood pressure level and hypertension status with coronary artery calcification (CAC), a measure of subclinical atherosclerosis, were restricted to participants who were physician- or self-referred, high risk, selected on hypertension status, or young adults.
803 asymptomatic individuals at least age 40 years were studied from a community. Blood pressure level was measured and blood pressure diagnostic category (i.e. hypertension vs. normotension) was determined by considering reported history of physician-diagnosed hypertension, use of antihypertensive medication, and measured blood pressure levels. CAC was measured non-invasively with electron beam computed tomography. Tobit regression models allowed simultaneous modeling of presence and quantity of CAC.
In men, age, having ever smoked, having hypertension, LDL-C level, and body mass index were significantly and positively associated with presence and quantity of CAC. In women, age, systolic blood pressure level, use of lipid lowering medications, and waist-to-hip ratio were significantly and positively associated with presence and quantity of CAC. Relationships of measures of blood pressure with CAC were modified by age, but no other risk factors, in both sexes.
Our results indicated that measures of blood pressure make a relatively large contribution to predictions of CAC at younger ages. CAC quantification, especially among younger individuals, may allow for early assessment of the presence and extent of target organ disease.