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CLINICAL RESEARCH

Renal Artery Calcium Is Independently Associated With Hypertension

Matthew A. Allison, MD, MPH^_*,,_*, Elizabeth O. Lillie, PhD, Dominic DiTomasso, BS, C. Michael Wright, MD and Michael H. Criqui, MD, MPH^_*,

^_* Department of Family and Preventive Medicine, University of California at San Diego, San Diego, California
Medicine, University of California at San Diego, San Diego, California
Bioengineering, University of California at San Diego, San Diego, California

Manuscript received April 2, 2007; revised manuscript received July 13, 2007, accepted July 16, 2007.

^_* Reprint requests and correspondence: Dr. Matthew A. Allison, 3855 Health Sciences Drive, Mailcode 0817, La Jolla, California 92093-0817. (Email: mallison{at}ucsd.edu).

Objectives: We tested the hypothesis that renal artery calcium (RAC), a marker of atherosclerotic plaque burden, is also significantly associated with higher blood pressure levels and a diagnosis of hypertension.

Background: In the nonrenal systemic vasculature, atherosclerotic plaque burden has been shown to be significantly associated with hypertension.

Methods: A total of 1,435 consecutive patients were evaluated at a university-affiliated disease prevention center for the extent of calcified atherosclerosis in the systemic vasculature.

Results: The overall prevalence of calcium in either renal artery was 17.1%, with men having a significantly higher prevalence (19.0%, 153 of 804) than women (14.7%, 93 of 631) (p = 0.03). After adjustment for age and gender, subjects with a RAC score >0 had a significantly higher prevalence of hypertension (41.2 vs. 29.5, p < 0.01). In a logistic model that adjusted for age, gender, body mass index, percent body fat, diabetes, smoking, dyslipidemia, and the extent of calcified atherosclerosis in the nonrenal vasculature, those with any RAC had a significantly higher odds ratio (1.61, p = 0.01) for hypertension than those with no RAC.

Conclusions: The results of this study suggest that the presence of RAC is associated with higher odds for prevalent hypertension, independent of CVD risk factors and the extent of calcified atherosclerosis in the nonrenal vasculature.

Abbreviations and Acronyms   CT = computed tomography   CVD = cardiovascular disease   DBP = diastolic blood pressure   HDL = high-density lipoprotein   HTN = hypertension   LDL = low-density lipoprotein   MAP = mean arterial pressure   PP = pulse pressure   RAC = renal artery calcium   SBP = systolic blood pressure

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