Key result
Hypertension is linked to ~71% higher odds of coronary artery calcification in symptomatic patients.
Why the study?
Do conventional cardiovascular risk factors such as hypertension and diabetes predict the presence and extent of coronary artery calcification in symptomatic patients?
Meta-Analysis (n=15,769)
Yes
Do conventional cardiovascular risk factors such as hypertension and diabetes predict the presence and extent of coronary artery calcification in symptomatic patients?
In symptomatic patients with chest pain or angina, hypertension and diabetes consistently predict both the presence and severity of coronary artery calcification, whereas dyslipidaemia, smoking, and obesity do not.
Answers are grounded in this paper and cite their sources.
Supports prioritizing hypertension and diabetes over dyslipidemia when estimating CAC burden in symptomatic patients; challenges assumed predictive roles of smoking and lipid levels.
BACKGROUND: The relationship of conventional cardiovascular risk factors (age, gender, ethnicity, diabetes, dyslipidaemia, hypertension, obesity, exercise, and the number of risk factors) to coronary artery calcification (CAC) presence and extent has never before been assessed in a systematic review and meta-analysis. METHODS: We included only English language studies that assessed at least three conventional risk factors apart from age, gender, and ethnicity, but excluded studies in which all patients had another confirmed condition such as renal disease. RESULTS: In total, 10 studies, comprising 15,769 patients, were investigated in the systematic review and seven studies, comprising 12,682 patients, were included in the meta-analysis, which demonstrated the importance of diabetes and hypertension as predictors of CAC presence and extent, with age also predicting CAC presence. Male gender, dyslipidaemia, family history of coronary artery disease, obesity, and smoking were overall not predictive of either CAC presence or extent, despite dyslipidaemia being a key risk factor for coronary artery disease (CAD). CONCLUSION: Diabetes and hypertension consistently predict the presence and extent of CAC in symptomatic patients.
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Nicoll et al. (2016) conducted a meta-analysis in Symptomatic chest pain or angina evaluated for coronary artery calcification (n=15,769). Conventional cardiovascular risk factors (hypertension, diabetes, male gender, age, dyslipidaemia, smoking, obesity, family history) vs. Absence of the respective cardiovascular risk factor was evaluated on Presence of coronary artery calcification (CAC score >0 or moderate-to-severe calcification on angiography) (OR 1.71, p=<0.00001). Hypertension and diabetes predicted the presence and severe extent of coronary artery calcification in symptomatic patients.
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