Observational studyThe American journal of cardiology2018
Relation of Coronary Artery Calcium and Extra-Coronary Aortic Calcium to Incident Hypertension (from the Multi-Ethnic Study of Atherosclerosis).
Observational study in The American journal of cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Vitamin K antagonists and cardiovascular calcification: A systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Association between blood pressure in the first-year post-kidney transplantation and pre-transplant coronary calcium scoring: a retrospective cohort study.Annals of medicine and surgery (2012) · 2025Article
- Article
- Insulin Resistance, Serum Calcium and Hypertension: A Cross-Sectional Study of a Multiracial Population, and a Similarity Assessment of Results from a Single-Race Population's Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Prediction of incident hypertension with the coronary artery calcium score based on the 2017 ACC/AHA high blood pressure guidelines.Hypertension research : official journal of the Japanese Society of Hypertension · 2020Article
- Coronary artery calcium scoring in patients with hypertension.Journal of human hypertension · 2020Review
- Catechol-O-Methyltransferase and Cardiovascular Disease: MESA.Journal of the American Heart Association · 2019Observational
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Authors and funding
11 authors.
Funding
Abstract
Arterial calcification reflects an atherosclerotic process associated with vascular stiffness. Whether baseline coronary artery calcium (CAC) and extra-coronary calcium (ECC), measured using noncontrast computed tomography imaging, are associated with incident hypertension is poorly understood. We studied participants from the Multi-Ethnic Study of Atherosclerosis without measured or self-reported hypertension at baseline. Incident hypertension was defined by blood pressure criteria (BP, ≥140/90 mmHg), BP medication use, or both, and was assessed at in-person visits. We analyzed incident hypertension using multivariable-adjusted discrete-time proportional hazards models. Net reclassification improvement (NRI) assessed whether CAC reclassified hypertension risk when added to the Framingham hypertension risk score. Among 3,304 subjects analyzed, mean age was 59 ± 10 years; 48% were male and 42% were white. There were 1,283 incident hypertension cases over a median (interquartile range) follow-up time of 10.6 (4.5, 11.5) years. Each 1-unit increase in ln(CAC+1) was independently associated with a 12% higher risk of hypertension (95% confidence interval [CI] 9% to 16%). Relative to CAC = 0, patients with CAC >400 had a hazard ratio for incident hypertension of 2.2 (95% CI 1.8 to 2.9). There was no interaction by age, gender, or baseline BP (p = 0.43, 0.19, 0.09, respectively). Continuous NRI analyses demonstrated that CAC can reclassify risk of incident hypertension; NRI = 0.19 (95% CI 0.10 to 0.26). Furthermore, all measurements of ECC were significantly associated with incident hypertension, even after adjustment for CAC (hazard ratios ranging from 1.36 to 1.38). In conclusion, patients with CAC and ECC are at markedly higher risk of incident hypertension and may benefit from more intensified prevention efforts.
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