title: Long-term prognosis for individuals with hypertension undergoing coronary artery calcium scoring.
abstract: BACKGROUND
  To examine the performance of coronary artery calcification (CAC) for stratifying long-term risk of death in asymptomatic hypertensive patients.
  
  
  RESULTS
  8905 consecutive asymptomatic individuals without cardiovascular disease or diabetes who underwent CAC testing (mean age 53.3 ± 10.5, 59.3% male) were followed for a mean of 14 years and categorized on the background of hypertension as well as age above or below 60 years (in accordance with the 2014 Guidelines from the Joint National Committee 8). The prevalence and severity of CAC were higher for those with hypertension versus without hypertension (P<0.001), and the extent increased proportionally with advancing age (P<0.001). Following adjustment, the presence of CAC in hypertensive with respect to normotensive, was associated with worse prognosis for individuals above the age of 60 years (HR 7.74 [95% CI: 5.15-11.63] vs. HR 4.83 [95% CI: 3.18-7.33]) than individuals below the age of 60 (HR 3.18 [95% CI: 2.42-4.19] vs. HR 2.14 [95% CI: 1.61-2.85]), respectively. A zero CAC score in hypertensive over the age of 60 years was associated with a lower but persisting risk of mortality for (HR 2.48 [95% CI: 1.50-4.08]) that was attenuated non-significant for those below the age of 60 years (P=0.09). In a "low risk" hypertensive population, the presence any CAC was associated with an almost five-fold (HR 4.68 [95% CI: 2.22-9.87]) increased risk of death.
  
  
  CONCLUSIONS
  The presence and extent of CAC effectively may help the clinicians to further discriminate the long-term risk of mortality among asymptomatic hypertensive individuals, beyond conventional cardiovascular risk and current guidelines.
authors: Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, United States.
authors: Valentina
authors: V
authors: Valenti
authors: Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, United States.
authors: Bríain
authors: B
authors: Ó Hartaigh
authors: Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, United States.
authors: Ran
authors: R
authors: Heo
authors: Division of Cardiology, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, United States.
authors: Joshua
authors: J
authors: Schulman-Marcus
authors: Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, United States.
authors: Iksung
authors: I
authors: Cho
authors: Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, United States.
authors: Dan K
authors: DK
authors: Kalra
authors: Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, United States.
authors: Quynh A
authors: QA
authors: Truong
authors: Division of Biostatistics and Epidemiology, Department of Public Health, Weill Cornell Medical College, New York, NY, United States.
authors: Ashley E
authors: AE
authors: Giambrone
authors: Division of Biostatistics and Epidemiology, Department of Public Health, Weill Cornell Medical College, New York, NY, United States.
authors: Heidi
authors: H
authors: Gransar
authors: Tennessee Heart and Vascular Institute, Hendersonville, TN, United States.
authors: Tracy Q
authors: TQ
authors: Callister
authors: Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States.
authors: Leslee J
authors: LJ
authors: Shaw
authors: Department of Medicine, Weill Cornell Medical College, New York, NY, United States.
authors: Fay Y
authors: FY
authors: Lin
authors: Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
authors: Hyuk-Jae
authors: HJ
authors: Chang
authors: IRCCS Neuromed, Pozzilli, IS, Italy.
authors: Sebastiano
authors: S
authors: Sciarretta
authors: Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, United States. Electronic address: jkm2001@med.cornell.edu.
authors: James K
authors: JK
authors: Min
mesh_terms: D000328:Adult; D002118:Calcium / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D003331:Coronary Vessels / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D061205:Vascular Calcification / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality
chemical_list: D002118:Calcium
keywords: All-cause mortality; Cardiac computed tomography; Coronary artery calcium; Hypertension