Prevalence and Correlates of Coronary Calcification in Black and White Young Adults

Abstract

Abstract-Whereas cardiovascular risk factor levels are substantially different in black and white Americans, the relative rates of cardiovascular disease in the 2 groups are not always consistent with these differences. To compare the prevalence of coronary calcification, an indicator of coronary atherosclerosis, in young adult blacks and whites, we performed electron-beam computed tomography of the heart in 443 men and women aged 28 to 40 years recruited from a population-based cohort. The presence of calcium, defined as at least 1 focus of at least 2.05 mm 2 in area and Ͼ130 Hounsfield units in density within the coronary arteries, was identified in 16.1% of black men, 11.8% of black women, 17.1% of white men, and 4.6% of white women (Pϭ0.04 for comparison across groups). Coronary calcium was associated with age and male sex, and after adjustment for age, race, and sex, coronary calcium was positively associated with body mass index, weight, systolic blood pressure, total cholesterol, low density lipoprotein cholesterol, triglycerides, and fasting insulin and negatively associated with education (all PϽ0.05). Independent risk factors included male sex, body mass index, and low density lipoprotein cholesterol. Race was not significantly associated with coronary calcium in men or women, before or after adjustment for risk factors. Coronary calcification is associated with increased levels of cardiovascular risk factors in young adults, and its prevalence is not significantly different in blacks and whites. Key Words: coronary heart disease Ⅲ risk factors Ⅲ race Ⅲ coronary artery calcification R elative levels of coronary risk factors in blacks and whites suggest that blacks would be at higher risk for coronary heart disease (CHD). 1-6 CHD mortality rates appear to reflect higher risk factor levels in blacks, 7 but CHD incidence is lower in black men than in white men. 8 Clues to possible racial differences in rates of CHD may be found by identifying subclinical disease for which treatment has not been instituted and which is not subject to the biases of disease ascertainment or death certificate coding. 9 -12 To compare the prevalence of a marker of coronary atherosclerosis in a population-based sample of young adult blacks and whites, to examine risk factor correlates, and to determine whether any racial differences in prevalence might be explained by risk factor differences, we measured coronary calcification by using electron-beam computed tomography (EBCT) of the heart and risk factors in men and women aged 28 to 40 years who have participated in an ongoing epidemiological study of the coronary disease risk factors. Coronary calcium is a specific marker for coronary atherosclerosis 13 and can be quantified by EBCT. 14 -16 Methods ParticipantsParticipants in the present study were from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. The baseline CARDIA examination took place from 1985 to 1986 and included 5115 women and men from 4 centers (Birmingham, Ala; Chicago, Ill; Minneapolis, Min...

Is Carotid Atherosclerosis More Important in Patients With Mitral Annular Calcification Than in Those Without?

“…2,23,24) Also, an association between MAC and aortic plaque and/or coronary calcification has been shown previously. [25][26][27] Recent data also suggest that cardiovascular calcification is a strong predictor for the presence of CAD and it was suggested that MAC is a manifestation of diffuse atherosclerosis of the vascular system.…”

Coronary calcification is more predictive of carotid intimal medial thickness in black compared to white middle aged men

“…Similarly, a number of studies have shown that black men had higher IMT of CCA than young, [17] middle age [18] and old white populations [19]. Two population based studies of middle aged men and women [20,21] and one prospective study in post-menopausal women [22] reported similar coronary calcification between black and white men. However, black men had lower coronary calcification in other epidemiological studies [23,24].…”

Premenopausal risk factors for coronary and aortic calcification: A 20-year follow-up in the healthy women study

“…(Bild et al 2001;Daviglus et al 2004;Mahoney et al 1998). Here we report cardiovascular risk factors measured prior to and after the menopause as predictors of CaC and AC measured 14.6 to 20.4 years later in 363 women enrolled in the Healthy Women Study.…”