The degree of hypertension was associated with an increased risk and severity of subclinical coronary atherosclerosis in asymptomatic individuals without cardiovascular disease.
Stage 1 hypertension was significantly associated with non-obstructive coronary artery disease after adjusting for cardiovascular risk factors.
Stage 2 hypertension was significantly associated with both non-obstructive and obstructive coronary artery disease.
The study population consisted of 7,332 asymptomatic individuals without cardiovascular disease who underwent coronary computed tomography angiography (CCTA) as part of a voluntary general health examination.
The severity of subclinical coronary atherosclerosis increased progressively with higher degrees of hypertension.
The findings highlight the potential importance of early recognition of blood pressure elevation and cardiovascular risk stratification in asymptomatic individuals.
This research suggests that higher levels of high blood pressure (hypertension) are linked to greater amounts of hidden (subclinical) plaque buildup in the coronary arteries — even in people who have no symptoms and no known heart disease. The study looked at over 7,300 adults who voluntarily had a specialized heart CT scan as part of a routine health check-up. Using blood pressure categories from updated American heart guidelines, the researchers found that people with stage 1 hypertension (moderately elevated blood pressure) were about 33% more likely to have partial blockages in their coronary arteries compared to people with normal blood pressure. People with stage 2 hypertension (more severely elevated blood pressure) were about 48% more likely to have partial blockages and about 70% more likely to have significant blockages. The study is notable because all participants felt healthy and had no diagnosed cardiovascular disease at the time of the scan. This means the coronary artery changes detected were 'silent' — not yet causing symptoms. The fact that even moderately elevated blood pressure was associated with these changes suggests that the cardiovascular impact of hypertension may begin earlier than symptoms appear. This research suggests that monitoring blood pressure levels carefully and assessing heart disease risk in people with even early-stage hypertension — before any symptoms develop — could be important for identifying those at elevated cardiovascular risk. The findings support the value of blood pressure classification systems that distinguish between different levels of elevation, rather than treating all below-threshold readings as equivalent.
Jang M, Park S, Ann S, Kim Y, Jeon Y, Lim S, et al.. (2026). Degree of hypertension and subclinical coronary atherosclerosis in asymptomatic individuals without cardiovascular disease.. PloS one. https://doi.org/10.1371/journal.pone.0353359