Diastolic blood pressure predicts coronary plaque volume in patients with coronary artery disease

Atherosclerosis. 2018 Oct:277:34-41. doi: 10.1016/j.atherosclerosis.2018.07.031. Epub 2018 Jul 29.

Abstract

Background and aims: Hypertension is associated with increased clinical and subclinical coronary artery disease (CAD); however, the relationship between blood pressure and coronary plaque volume is unclear. We examined the effect of systolic blood pressure (SBP) and diastolic blood pressure (DBP) on coronary artery plaque volume.

Methods: 285 subjects with stable CAD on statin therapy underwent coronary computed tomographic angiography to measure volume of fatty, fibrous, noncalcified, calcified and total coronary plaque.

Results: Mean (SD) age was 63.1 (7.7); mean (SD) LDL-C, 78.7 mg/dL (28.5). Compared to the highest DBP tertile (>76 mmHg), those in the lowest DBP tertile (≤68 mmHg) had lower volumes of fatty: 10.0 vs. 7.7 mm3/mm, (p trend = 0.042), fibrous: 19.6 vs. 13.8 mm3/mm (p trend = 0.011), non-calcified: 29.7 vs. 22.5 mm3/mm (p trend = 0.017) and total plaque: 37.8 vs. 25.1 mm3/mm (p trend = 0.010) whereas there was no relationship with SBP tertiles. Similarly, when examined as a continuous variable, higher DBP was a significant independent predictor of higher plaque volume after multivariate adjustment: for every 1 mmHg increase in DBP, fibrous plaque increased 0.128 mm3/mm (p = 0.022), noncalcified plaque increased 0.176 mm3/mm (p = 0.045), calcified plaque increased 0.096 mm3/mm (p = 0.001) and total plaque increased 0.249 mm3/mm (p = 0.019) whereas SBP ranging from 95 to 154 mmHg did not predict plaque volume.

Conclusions: Level of DBP predicts coronary plaque with a DBP tertile ≤68 mmHg associated with the least amount of coronary plaque in subjects with LDL-C < 80 mg/dL.

Keywords: Coronary computed tomographic angiography; Coronary plaque; Diastolic blood pressure; Systolic blood pressure.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure*
  • Computed Tomography Angiography*
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / etiology*
  • Coronary Artery Disease / physiopathology
  • Coronary Vessels / diagnostic imaging*
  • Cross-Sectional Studies
  • Diastole
  • Female
  • Fibrosis
  • Humans
  • Hypertension / complications*
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic*
  • Predictive Value of Tests
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / etiology
  • Vascular Calcification / physiopathology
  • Young Adult