Could regular calcium scans save the life of person with high blood pressure?

This study investigated whether calcium deposits in the arteries that supply the heart muscle (a condition known as coronary artery calcification) in patients with high blood pressure predicts the occurrence of heart events, such as heart attack. 

High blood pressure occurs when pressure inside blood vessels is too high. Patients who have high blood pressure have a higher risk of developing coronary artery disease. Coronary artery disease occurs when plaque, made up of cholesterol, fat and calcium, builds up inside the walls of arteries that supply blood to the heart muscle (called coronary arteries). The build up causes the arteries to narrow. If the coronary arteries become completely blocked it leads to a heart attack.

The degree of calcium accumulation inside the coronary arteries may be a good indicator of a person's risk of having a heart event such as heart attack. Calcium scans provide images of the coronary arteries to visualise calcium deposits. The result of this test is called a coronary artery calcification (CAC) score and when combined with other health information is used to measure a person's risk of coronary artery disease or heart attack.

This study investigated whether the calcium or CAC score determines the risk of having a heart event among patients with high blood pressure. 

A total of 210 patients of an average age of 64 years were included in the study. All patients had no symptoms for coronary artery disease at the start of the study. Three categories of how severe the CAC score increased or progressed over the study period were used. These included non-progressors, slow progressors and rapid progressors. Cardiovascular events included heart attack, hospitalization for irregular heartbeat or surgery for narrowing arteries. 

During 15 years of follow-up, 83 patients experienced a heart event. Out of these patients, the rate of heart events was highest among rapid progressors (49% of rapid progressors experienced a heart event) and among the slow progressors (46%) compared to nonprogressors (25%). When compared with nonprogression, slow progression was associated with a 91% increased risk of dying from a heart event and rapid progression was associated with a 2-fold increased risk of dying from a heart event. 

Patients with high blood pressure are at a higher risk of developing coronary artery disease and experiencing heart events such as a heart attack. This study concluded that measuring CAC scores helps to measure this risk. The investigators found that regardless of the CAC score at the start of the study, if the CAC score increases, be it slowly or rapidly, patients have a higher risk of having a heart event than patients with no progression of CAC. 

This study included a relatively small group of patients with high blood pressure and may not reflect all patients with high blood pressure. 

If you or someone you know have high blood pressure, talk to a doctor about having regular coronary calcium scans to see if intensive treatment may be required.