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 Maffei; Gilbert 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

doi:10.1161/HYPERTENSIONAHA.117.09402

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 Maffei

Gilbert 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

Clinic for Heart and Vascular Diseases

Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
Cedars-Sinai Medical Center
Weill Cornell Medicine
Friedrich Alexander Universität Erlangen-Nürnberg
King Saud bin Abdulaziz University for Health Sciences
H1 T 1C8
Erasmus University Medical Center
Tennessee Heart and Vascular Institute
Severance Cardiovascular Hospital
William Beaumont Hospital
University of Ottawa
Capitol Cardiology Associates
University of Munich
Baptist Neuroscience Institute
Medical University Innsbruck
Seoul National University Hospital
University of British Columbia
University Hospital Zurich
Emory University School of Medicine
Walter Reed Medical Center
Duke Clinical Research Institute
Hospital da Luz
University of Milan
Istituto di Ricovero e Cura A Carattere Scientifico (IRCCS)
Technion - Israel Institute of Technology
Leiden University Medical Centre

Research output: Contribution to journal › Article › peer-review

69 Scopus citations

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 language	English
Pages (from-to)	293-299
Number of pages	7
Journal	Hypertension
Volume	70
Issue number	2
DOIs	https://doi.org/10.1161/HYPERTENSIONAHA.117.09402
State	Published - 1 Aug 2017

Keywords

angiography
atherosclerosis
coronary artery disease
hypertension
risk factors

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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

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title = "Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients with Coronary Computed Tomographic Angiography",

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.",

keywords = "angiography, atherosclerosis, coronary artery disease, hypertension, risk factors",

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

note = "Publisher Copyright: {\textcopyright} 2017 American Heart Association, Inc.",

year = "2017",

month = aug,

day = "1",

doi = "10.1161/HYPERTENSIONAHA.117.09402",

language = "English",

volume = "70",

pages = "293--299",

journal = "Hypertension",

issn = "0194-911X",

publisher = "Lippincott Williams and Wilkins",

number = "2",

}

Nakanishi, R, Baskaran, L, Gransar, H, Budoff, MJ, Achenbach, S, Al-Mallah, M, Cademartiri, F, Callister, TQ, Chang, HJ, Chinnaiyan, K, Chow, BJW, De Lago, A, Hadamitzky, M, Hausleiter, J, Cury, R, Feuchtner, G, Kim, YJ, Leipsic, J, Kaufmann, PA, Maffei, E, Raff, G, Shaw, LJ, Villines, TC, Dunning, A, Marques, H, Pontone, G, Andreini, D, Rubinshtein, R, Bax, J, Jones, E, Hindoyan, N, Gomez, M, Lin, FY, Min, JK & Berman, DS 2017, 'Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients with Coronary Computed Tomographic Angiography', Hypertension, vol. 70, no. 2, pp. 293-299. https://doi.org/10.1161/HYPERTENSIONAHA.117.09402

TY - JOUR

T1 - Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients with Coronary Computed Tomographic Angiography

AU - Nakanishi, Rine

AU - Baskaran, Lohendran

AU - Gransar, Heidi

AU - Budoff, Matthew J.

AU - Achenbach, Stephan

AU - Al-Mallah, Mouaz

AU - Cademartiri, Filippo

AU - Callister, Tracy Q.

AU - Chang, Hyuk Jae

AU - Chinnaiyan, Kavitha

AU - Chow, Benjamin J.W.

AU - De Lago, Augustin

AU - Hadamitzky, Martin

AU - Hausleiter, Joerg

AU - Cury, Ricardo

AU - Feuchtner, Gudrun

AU - Kim, Yong Jin

AU - Leipsic, Jonathon

AU - Kaufmann, Philipp A.

AU - Maffei, Erica

AU - Raff, Gilbert

AU - Shaw, Leslee J.

AU - Villines, Todd C.

AU - Dunning, Allison

AU - Marques, Hugo

AU - Pontone, Gianluca

AU - Andreini, Daniele

AU - Rubinshtein, Ronen

AU - Bax, Jeroen

AU - Jones, Erica

AU - Hindoyan, Niree

AU - Gomez, Millie

AU - Lin, Fay Y.

AU - Min, James K.

AU - Berman, Daniel S.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - 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.

AB - 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.

KW - angiography

KW - atherosclerosis

KW - coronary artery disease

KW - hypertension

KW - risk factors

UR - https://www.scopus.com/pages/publications/85020723035

U2 - 10.1161/HYPERTENSIONAHA.117.09402

DO - 10.1161/HYPERTENSIONAHA.117.09402

M3 - Article

C2 - 28607128

AN - SCOPUS:85020723035

SN - 0194-911X

VL - 70

SP - 293

EP - 299

JO - Hypertension

JF - Hypertension

IS - 2

ER -

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

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Keywords

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