title: Uncontrolled hypertension is associated with coronary artery calcification and electrocardiographic left ventricular hypertrophy: a case-control study.
abstract: We conducted a 1:2 matched case-control study in order to evaluate whether the prevalence of coronary artery calcium (CAC) and electrocardiographic left ventricular hypertrophy (LVH) or strain was higher in patients with uncontrolled hypertension than in subjects from the general population, and evaluate the association between CAC and LVH in patients with uncontrolled hypertension. Cases were patients with uncontrolled hypertension, whereas the controls were random individuals from the general population without cardiovascular disease. CAC score was assessed using a non-contrast computed tomographic scan. LVH was evaluated using the Sokolow-Lyon voltage combination and Cornell voltage-duration product, respectively. Associations between CAC, LVH and traditional cardiovascular risk factors were tested by means of ordinal, conditional and classic binary logistic regression models. We found that uncontrolled hypertension was independently associated with both an ordinal CAC score category (odds ratio (OR) 3.9 (95% CI, 1.6-9.1), P = 0.002), the presence of CAC score>99 (OR 4.5 (95% CI, 1.4-14.7), P = 0.01) and electrocardiographic LVH (OR 10.1 (95% CI, 3.4-30.2), P < 0.001) on both univariate and multivariable analyses. There was, however, no correlation between CAC and LVH. The lack of an association between CAC and LVH suggests that they are markers of different complications of hypertension and may have independent predictive values. Patients with both CAC and LVH may be at higher risk than those in whom only one of these markers is present.
authors.affiliation: Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark.
authors.forename: M L
authors.initials: ML
authors.lastname: Nielsen
authors.affiliation: Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Pareek
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, Odense and Centre of Health Economics Research, University of Southern Denmark, Odense, Denmark.
authors.forename: O
authors.initials: O
authors.lastname: Gerke
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark.
authors.forename: S Z
authors.initials: SZ
authors.lastname: Diederichsen
authors.affiliation: Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark.
authors.forename: S V
authors.initials: SV
authors.lastname: Greve
authors.affiliation: Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark.
authors.forename: M K
authors.initials: MK
authors.lastname: Blicher
authors.affiliation: Department of Cardiology, Sydvestjysk Hospital, Esbjerg, Denmark.
authors.forename: N P R
authors.initials: NP
authors.lastname: Sand
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Mickley
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark.
authors.forename: A C P
authors.initials: AC
authors.lastname: Diederichsen
authors.affiliation: 1] Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark [2] Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
authors.forename: M H
authors.initials: MH
authors.lastname: Olsen
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002114:Calcinosis; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D003718:Denmark / Q000453:epidemiology; D004351:Drug Resistance; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000959:Antihypertensive Agents