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. 2022 Aug;45(8):873-881.
doi: 10.1002/clc.23870. Epub 2022 Jun 8.

Longitudinal quantitative assessment of coronary atherosclerosis related to normal systolic blood pressure maintenance in the absence of established cardiovascular disease

Ki-Bum Won  1   2   3 , Hyung-Bok Park  3   4 , Ran Heo  3   5 , Byoung Kwon Lee  6 , Fay Y Lin  7 , Martin Hadamitzky  8 , Yong-Jin Kim  9 , Ji Min Sung  2   3 , Edoardo Conte  10 , Daniele Andreini  10 , Gianluca Pontone  10 , Matthew J Budoff  11 , Ilan Gottlieb  12 , Eun Ju Chun  13 , Filippo Cademartiri  14 , Erica Maffei  15 , Hugo Marques  16 , Pedro de Araújo Gonçalves  16   17 , Jonathon A Leipsic  18 , Sang-Eun Lee  3   19 , Sanghoon Shin  3   19 , Jung Hyun Choi  20 , Renu Virmani  21 , Habib Samady  22 , Kavitha Chinnaiyan  23 , Daniel S Berman  24 , Jagat Narula  25 , Jeroen J Bax  26 , James K Min  7 , Hyuk-Jae Chang  2   3
Affiliations

Longitudinal quantitative assessment of coronary atherosclerosis related to normal systolic blood pressure maintenance in the absence of established cardiovascular disease

Ki-Bum Won et al. Clin Cardiol. 2022 Aug.

Abstract

Background: Atherosclerosis-related adverse events are commonly observed even in conditions with low cardiovascular (CV) risk. Longitudinal data regarding the association of normal systolic blood pressure maintenance (SBPmaintain ) with coronary plaque volume changes (PVC) has been limited in adults without traditional CV disease.

Hypothesis: Normal SBPmaintain is important to attenuate coronary atherosclerosis progression in adults without baseline CV disease.

Methods: We analyzed 95 adults (56.7 ± 8.5 years; 40.0% men) without baseline CV disease who underwent serial coronary computed tomographic angiography with mean 3.5 years of follow-up. All participants were divided into two groups of normal SBPmaintain (follow-up SBP < 120 mm Hg) and ≥elevated SBPmaintain (follow-up SBP ≥ 120 mm Hg). Annualized PVC was defined as PVC divided by the interscan period.

Results: Compared to participants with normal SBPmaintain , those with ≥elevated SBPmaintain had higher annualized total PVC (mm3 /year) (0.0 [0.0-2.2] vs. 4.1 [0.0-13.0]; p < .001). Baseline total plaque volume (β = .10) and the levels of SBPmaintain (β = .23) and follow-up high-density lipoprotein cholesterol (β = -0.28) were associated with annualized total PVC (all p < .05). The optimal cutoff of SBPmaintain for predicting plaque progression was 118.5 mm Hg (sensitivity: 78.2%, specificity: 62.5%; area under curve: 0.700; 95% confidence interval [CI]: 0.59-0.81; p < .05). SBPmaintain ≥ 118.5 mm Hg (odds ratio [OR]: 4.03; 95% CI: 1.51-10.75) and baseline total plaque volume (OR: 1.03; 95% CI: 1.01-1.06) independently influenced coronary plaque progression (all p < .05).

Conclusion: Normal SBPmaintain is substantial to attenuate coronary atherosclerosis progression in conditions without established CV disease.

Keywords: atherosclerosis; coronary artery disease; coronary computed tomography angiography; systolic blood pressure.

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Conflict of interest statement

Dr. James K. Min receives funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare. Dr. Min serves on the scientific advisory board of Arineta and GE Healthcare, and has an equity interest in Cleerly. Dr. Habib Samaday has equity interest in Covanos. Dr. Leipsic serves as a consultant and has stock options in HeartFlow and Circle Cardiovascular Imaging; and receives grant support from GE Healthcare and speaking fees from Philips. All other authors declared no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of annualized total PVC according to follow‐up SBP. PVC, plaque volume changes; SBP, systolic blood pressure; SBPmaintain, systolic blood pressure maintenance
See this image and copyright information in PMC

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