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(Hypertension. 2008;52:833.)
© 2008 American Heart Association, Inc.

Original Articles

Association Between Different Measures of Blood Pressure and Coronary Artery Calcium in Postmenopausal Women

Matthew A. Allison; JoAnn E. Manson; Robert D. Langer; Aaron Aragaki; Sylvia Smoller; Cora E. Lewis; Asha Thomas; William Lawson; Barbara B. Cochrane; Judith Hsia; Julie R. Hunt; Jennifer Robinson

From the University of California San Diego (M.A.A.), La Jolla, Calif; Brigham and Women’s Hospital (J.E.M.), Harvard Medical School, Boston, Mass; Geisinger Health Systems (R.D.L.), Danville, Pa; Fred Hutchinson Cancer Research Center (A.A., J.R.H.), Seattle, Wash; Albert Einstein School of Medicine (S.S.), Bronx, NY; University of Alabama at Birmingham (C.E.L.); MedStar (A.T.), Washington, DC; New York University (W.L.), Stony Brook, NY; University of Washington, Seattle (B.B.C.); Astra Zeneca LLP (J.H.), Wilmington, Del; and University of Iowa (J.R.), Iowa City.

Correspondence to Matthew A. Allison, MD, MPH, 8950 Villa La Jolla Dr, Suite B-122, La Jolla, CA 92093-0811. E-mail mallison{at}ucsd.edu

The aim of this study was to determine the magnitude and significance of the associations among coronary artery calcium (CAC) and systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure. Women 50 to 59 years of age at baseline in the Women’s Health Initiative clinical trial of conjugated equine estrogen underwent computed tomography scanning of the chest after the end of the trial. Blood pressures were measured twice with the participant in the seated position using a conventional mercury sphygmomanometer. The study included 1064 women with a mean age of 55.1 (2.8) years. The prevalence of a CAC score >0, 10, and >100 was 47%, 39%, and 19%, respectively. There was a linear association between the log-odds of any CAC and systolic blood pressure, whereas there was a curvilinear and inverse association with diastolic blood pressure. For any value of diastolic blood pressure, the probability of CAC increased with higher levels of systolic blood pressure, whereas for any given value of systolic blood pressure, the probability of any CAC decreased with higher levels of diastolic blood pressure. Also, a pulse pressure 55 mm Hg was associated with a higher odds (1.95; 95% CI, 1.24 to 3.06) for having any CAC, whereas individuals with isolated systolic hypertension had a 73% higher odds for CAC >0 (95% CI, 1.03 to 2.90; P=0.04). In postmenopausal women, higher levels of pulse pressure and systolic blood pressure were strong determinants of CAC, whereas diastolic blood pressure was inversely related.

Key Words: calcium • coronary • pulse pressure • women • coronary artery disease • atherosclerosis • postmenopausal