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

Journal of Human Hypertension volume 29, pages 303–308 (2015)Cite this article

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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.

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Authors and Affiliations

  1. Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark

    M L Nielsen, M Pareek, S V Greve, M K Blicher & M H Olsen

  2. Department of Nuclear Medicine, Odense University Hospital, Odense and Centre of Health Economics Research, University of Southern Denmark, Odense, Denmark

    O Gerke

  3. Department of Cardiology, Odense University Hospital, Odense, Denmark

    S Z Diederichsen, H Mickley & A C P Diederichsen

  4. Department of Cardiology, Sydvestjysk Hospital, Esbjerg, Denmark

    N P R Sand

  5. Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa

    M H Olsen

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  1. M L Nielsen
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Correspondence to M L Nielsen.

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Nielsen, M., Pareek, M., Gerke, O. et al. Uncontrolled hypertension is associated with coronary artery calcification and electrocardiographic left ventricular hypertrophy: a case-control study. J Hum Hypertens 29, 303–308 (2015). https://doi.org/10.1038/jhh.2014.88

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