{
  "abstract": "Objectives To assess the association of normal systolic blood pressure maintenance (SBP maintain) with coronary artery calcification (CAC) progression in non-diabetic and diabetic subjects at low to intermediate cardiovascular risk.Design Retrospective cohort study with a mean follow-up of 3.3 years.Setting Data from the Korea Initiatives on Coronary Artery Calcification registry were analysed.Participants 10 754 asymptomatic Korean adults (51.5±8.6 years; 84.5% male; 14.2% diabetes) were enrolled. Participants were divided into two groups: normal SBP maintain (<120 mmHg) and ≥elevated SBPmaintain (≥120 mmHg) at the time of follow-up CAC scan.Main outcome measures CAC progression was defined as a difference of ≥2.5 between the square roots (√) of the baseline and follow-up coronary artery calcium score (CACS) (Δ√transformed CACS). Annualised Δ√transformed CACS was defined as Δ√transformed CACS divided by the interscan period.Results Compared with non-diabetics, the incidence of CAC progression was higher in diabetics (28.4% vs 47.3%, p<0.001) during a mean follow-up of 3.3 years. Normal SBP maintain was inversely associated with an annualised Δ√transformed CACS (β: −0.18, 95% CI: −0.25 to −0.12, p<0.001) in non-diabetics, but not in diabetics (β: −0.07, 95% CI: −0.31 to 0.19, p=0.631). After consecutive adjustments of age, sex, hypertension, dyslipidaemia, obesity, current smoking and baseline CACS, normal SBPmaintain showed a lower risk of CAC progression than ≥elevated SBPmaintain in non-diabetics; however, this association was not observed in patients with diabetes.Conclusions Maintaining normal systolic blood pressure was associated with a significantly attenuated CAC progression, especially in clinical conditions without established diabetes.",
  "authors": [
    {
      "affiliations": [
        "Chung-Ang University College of Medicine, Dongjak-gu, Seoul, Republic of Korea"
      ],
      "name": "Ki-Bum Won"
    },
    {
      "affiliations": [
        "Internal Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea"
      ],
      "name": "Su-Yeon Choi"
    },
    {
      "affiliations": [
        "Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea"
      ],
      "name": "Eun Ju Chun"
    },
    {
      "affiliations": [
        "Gangnam Heartscan Clinic, Seoul, Republic of Korea"
      ],
      "name": "Sung Hak Park"
    },
    {
      "affiliations": [
        "Samsung Medical Center, Gangnam-gu, Republic of Korea"
      ],
      "name": "Jidong Sung"
    },
    {
      "affiliations": [
        "The Catholic University of Korea, Jongno-gu, Republic of Korea"
      ],
      "name": "Hae Ok Jung"
    },
    {
      "affiliations": [
        "Yonsei University Health System, Seodaemun-gu, Republic of Korea"
      ],
      "name": "Hyuk Jae Chang"
    }
  ],
  "title": "Association between normal systolic blood pressure maintenance and the risk of coronary artery calcification progression in asymptomatic non-diabetic and diabetic adults: a retrospective cohort study using data from the Korea initiatives on coronary artery calcification registry",
  "uid": "d613c4b0-aaa1-5b3d-899a-5eb732cc509b"
}