Coronary calcium is a key predictor of which patients with prehypertension will go on to have cardiovascular events, particularly in women, according to data from the Heinz Nixdorf RECALL study presented here at the 2013 International Conference on Prehypertension and Cardiometabolic Syndrome.
And in extended follow-up of that cohort—now almost 10 years—roughly half of all men and women with blood pressures in the prehypertension range at the study outset have developed stage 1 or 2 hypertension, Dr Raimund Erbel (University Clinic Essen, Germany), who presented the study, told heartwire.
According to Erbel, coronary artery calcium (CAC) tests may, in the future, help physicians decide which prehypertensive patients should be targeted for more intensive management. The data also provide one clue to a question repeatedly posed at this meeting: how can trials testing lifestyle or drug interventions identify the best patients to enroll, in order to get hard-end-point data within a reasonably sized study within a relatively short study duration?
Erbel already has a trial in mind and predictions for what it will yield. "A new study where we select prehypertensive patients with and without coronary artery calcium will show that treatment in those patients with atherosclerotic disease is where our preventive medicine really has to be concentrated."