Longitudinal quantitative assessment of coronary atherosclerosis related to normal systolic blood pressure maintenance in the absence of established cardiovascular disease.

Background: Atherosclerosis-related adverse events are commonly observed even in conditions with low cardiovascular (CV) risk. Longitudinal data regarding the association of normal systolic blood pressure maintenance (SBP _maintain ) with coronary plaque volume changes (PVC) has been limited in adults without traditional CV disease.
Hypothesis: Normal SBP _maintain is important to attenuate coronary atherosclerosis progression in adults without baseline CV disease.
Methods: We analyzed 95 adults (56.7 ± 8.5 years; 40.0% men) without baseline CV disease who underwent serial coronary computed tomographic angiography with mean 3.5 years of follow-up. All participants were divided into two groups of normal SBP _maintain (follow-up SBP < 120 mm Hg) and ≥elevated SBP _maintain (follow-up SBP ≥ 120 mm Hg). Annualized PVC was defined as PVC divided by the interscan period.
Results: Compared to participants with normal SBP _maintain , those with ≥elevated SBP _maintain had higher annualized total PVC (mm ³ /year) (0.0 [0.0-2.2] vs. 4.1 [0.0-13.0]; p < .001). Baseline total plaque volume (β = .10) and the levels of SBP _maintain (β = .23) and follow-up high-density lipoprotein cholesterol (β = -0.28) were associated with annualized total PVC (all p < .05). The optimal cutoff of SBP _maintain for predicting plaque progression was 118.5 mm Hg (sensitivity: 78.2%, specificity: 62.5%; area under curve: 0.700; 95% confidence interval [CI]: 0.59-0.81; p < .05). SBP _maintain  ≥ 118.5 mm Hg (odds ratio [OR]: 4.03; 95% CI: 1.51-10.75) and baseline total plaque volume (OR: 1.03; 95% CI: 1.01-1.06) independently influenced coronary plaque progression (all p < .05).
Conclusion: Normal SBP _maintain is substantial to attenuate coronary atherosclerosis progression in conditions without established CV disease.
(© 2022 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.)