Grace Ballas Research Unit of the Cardiac Rehabilitation Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Am J Hypertens. 2011 Jun;24(6):681-6. doi: 10.1038/ajh.2011.28. Epub 2011 Mar 3.
Coronary artery calcification (CAC) predicts mortality in normotensive individuals. We hypothesized that CAC has an impact on long-term mortality in hypertensive patients.
We followed 423 participants of the INSIGHT (International Nifedipine Study Intervention as Goal for Hypertension Therapy) calcification substudy, for the incidence of mortality as a function of CAC. All patients were hypertensive (mean age 64 ± 6 years, 48% male), without coronary artery or peripheral vascular disease, aged >55 years and with at least one more major cardiovascular (CV) risk factor. All underwent a baseline computed tomography (CT) (Dual slice) to determine the calcification score and were followed for a mean period of 14 ± 0.5 years. Mortality and the cause of death were derived from the registry of the Ministry-of-Interior Affairs.
During the follow-up, 94 patients died; 27 from CV causes, 54 from non-CV causes and 13 of undefined causes. The prevalence of calcification at baseline was 59% (195/329) among the survivors compared to 82% (77/94) in participants who died and 96.7% (26/27) among those who died of CV causes. The incidence of CV death was 14 times higher among those with than those without CAC (9.6% (26/272) vs. 0.7% (1/151); P < 0.01). After adjusting for age, gender, left ventricular hypertrophy, proteinuria, duration of hypertension, and renal function the presence of calcification predicted all cause mortality with a hazard ratio (HR) of 1.8 (95% confidence interval (CI) 1.04-3.07).
CAC is associated with long-term mortality in asymptomatic hypertensive adults.
冠状动脉钙化（CAC）可预测血压正常个体的死亡率。我们假设 CAC 对高血压患者的长期死亡率有影响。
我们对 INSIGHT（硝苯地平国际研究干预以达到高血压治疗目标）钙化子研究的 423 名参与者进行了随访，以 CAC 为函数，观察死亡率的发生率。所有患者均为高血压（平均年龄 64 ± 6 岁，48%为男性），无冠状动脉或外周血管疾病，年龄>55 岁，且至少有一个以上主要心血管（CV）危险因素。所有患者均接受基线计算机断层扫描（CT）（双螺旋）以确定钙化评分，并平均随访 14 ± 0.5 年。死亡率和死因均来自内政部登记处。
随访期间，94 名患者死亡；27 例死于 CV 原因，54 例死于非 CV 原因，13 例死因不明。与存活者（59%，195/329）相比，死亡者（82%，77/94）和死于 CV 原因者（96.7%，26/27）的基线钙化患病率更高。有 CAC 者的 CV 死亡发生率是无 CAC 者的 14 倍（9.6%（26/272）vs. 0.7%（1/151）；P<0.01）。在校正年龄、性别、左心室肥厚、蛋白尿、高血压持续时间和肾功能后，钙化的存在预测了全因死亡率，风险比（HR）为 1.8（95%置信区间（CI）为 1.04-3.07）。
CAC 与无症状高血压成年人的长期死亡率相关。
