Uncontrolled hypertension is associated with coronary artery calcification and electrocardiographic left ventricular hypertrophy: a case-control study

Mette Lundgren Nielsen, Manan Pareek, O Gerke, S Z Diederichsen, S V Greve, M K Blicher, N P R Sand, H Mickley, A C P Diederichsen, M H Olsen

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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.Journal of Human Hypertension advance online publication, 2 October 2014; doi:10.1038/jhh.2014.88.

Original languageEnglish
JournalJournal of Human Hypertension
Volume29
Issue number5
Pages (from-to)303-308
ISSN0950-9240
DOIs
Publication statusPublished - May 2015

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Left Ventricular Hypertrophy
Case-Control Studies
Odds Ratio
Logistic Models
Population
Publications

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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.Journal of Human Hypertension advance online publication, 2 October 2014; doi:10.1038/jhh.2014.88.",
author = "Nielsen, {Mette Lundgren} and Manan Pareek and O Gerke and Diederichsen, {S Z} and Greve, {S V} and Blicher, {M K} and Sand, {N P R} and H Mickley and Diederichsen, {A C P} and Olsen, {M H}",
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Uncontrolled hypertension is associated with coronary artery calcification and electrocardiographic left ventricular hypertrophy : a case-control study. / Nielsen, Mette Lundgren; Pareek, Manan; Gerke, O; Diederichsen, S Z; Greve, S V; Blicher, M K; Sand, N P R; Mickley, H; Diederichsen, A C P; Olsen, M H.

In: Journal of Human Hypertension, Vol. 29, No. 5, 05.2015, p. 303-308.

Research output: Contribution to journalJournal articleResearchpeer-review

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T1 - Uncontrolled hypertension is associated with coronary artery calcification and electrocardiographic left ventricular hypertrophy

T2 - a case-control study

AU - Nielsen, Mette Lundgren

AU - Pareek, Manan

AU - Gerke, O

AU - Diederichsen, S Z

AU - Greve, S V

AU - Blicher, M K

AU - Sand, N P R

AU - Mickley, H

AU - Diederichsen, A C P

AU - Olsen, M H

PY - 2015/5

Y1 - 2015/5

N2 - 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.Journal of Human Hypertension advance online publication, 2 October 2014; doi:10.1038/jhh.2014.88.

AB - 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.Journal of Human Hypertension advance online publication, 2 October 2014; doi:10.1038/jhh.2014.88.

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DO - 10.1038/jhh.2014.88

M3 - Journal article

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VL - 29

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JO - Journal of Human Hypertension

JF - Journal of Human Hypertension

SN - 0950-9240

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