Jeonggyu Kang1, Yoosoo Chang2, Seolhye Kim1, Ki-Chul Sung3, Hocheol Shin4, Seungho Ryu5. 1. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. Electronic address: yoosoo.chang@samsung.com. 3. Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 4. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. 5. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. Electronic address: sh703.yoo@samsung.com.
Abstract
BACKGROUND AND AIMS: The relationship between blood pressure (BP) levels given in the new hypertension guidelines by the American College of Cardiology and the American Heart Association (ACC/AHA) and subclinical coronary atherosclerosis in low-risk young adults is unknown. We evaluated the association between the new BP categories and coronary artery calcium (CAC) in low-risk, young and middle-aged adults. METHODS: We performed a cross-sectional study of 96,166 Koreans who underwent a health examination including cardiac tomography estimation of CAC scores in 2012-2017. BP categories were defined according to the 2017 ACC/AHA guidelines. We used Poisson regression models with robust variance to calculate prevalence ratios (PRs) with 95% confidence intervals (CIs) for prevalent CAC >0. RESULTS: Overall, higher BP categories were associated with higher CAC scores in both young (aged 20-39) and middle-aged people (aged 40 years or more). After adjusting for possible confounders, including traditional cardiovascular disease (CVD) risk factors, the multivariable-adjusted PRs (95% CI) for prevalent CAC, comparing elevated BP and stage 1 and 2 hypertension to normal BP, were 1.27 (1.08-1.49), 1.45 (1.28-1.63), and 2.02 (1.67-2.43), respectively, among those aged 20-39 years and 1.25 (1.15-1.36), 1.29 (1.23-1.35), and 1.46 (1.36-1.57), respectively, among those aged ≥40 years. This association was also evident in those with a 10-year CVD risk of <10%. CONCLUSIONS: Higher BP categories were positively associated with prevalent CAC, and that association began in the elevated BP category, even in a young and low-risk population.
BACKGROUND AND AIMS: The relationship between blood pressure (BP) levels given in the new hypertension guidelines by the American College of Cardiology and the American Heart Association (ACC/AHA) and subclinical coronary atherosclerosis in low-risk young adults is unknown. We evaluated the association between the new BP categories and coronary artery calcium (CAC) in low-risk, young and middle-aged adults. METHODS: We performed a cross-sectional study of 96,166 Koreans who underwent a health examination including cardiac tomography estimation of CAC scores in 2012-2017. BP categories were defined according to the 2017 ACC/AHA guidelines. We used Poisson regression models with robust variance to calculate prevalence ratios (PRs) with 95% confidence intervals (CIs) for prevalent CAC >0. RESULTS: Overall, higher BP categories were associated with higher CAC scores in both young (aged 20-39) and middle-aged people (aged 40 years or more). After adjusting for possible confounders, including traditional cardiovascular disease (CVD) risk factors, the multivariable-adjusted PRs (95% CI) for prevalent CAC, comparing elevated BP and stage 1 and 2 hypertension to normal BP, were 1.27 (1.08-1.49), 1.45 (1.28-1.63), and 2.02 (1.67-2.43), respectively, among those aged 20-39 years and 1.25 (1.15-1.36), 1.29 (1.23-1.35), and 1.46 (1.36-1.57), respectively, among those aged ≥40 years. This association was also evident in those with a 10-year CVD risk of <10%. CONCLUSIONS: Higher BP categories were positively associated with prevalent CAC, and that association began in the elevated BP category, even in a young and low-risk population.
Authors: Albert D Osei; S M Iftekhar Uddin; Omar Dzaye; Miguel Cainzos Achirica; Zeina A Dardari; Olufunmilayo H Obisesan; Sina Kianoush; Mohammadhassan Mirbolouk; Olusola A Orimoloye; Leslee Shaw; John A Rumberger; Daniel Berman; Alan Rozanski; Michael D Miedema; Matthew J Budoff; Ramachandran S Vasan; Khurram Nasir; Michael J Blaha Journal: Atherosclerosis Date: 2020-04-09 Impact factor: 5.162