Abstract P386: Adult Height and Coronary Artery Calcium in the NHLBI Family Heart Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Michael D Miedema ◽  
Andrew Petrone ◽  
James Pankow ◽  
Steven C Hunt ◽  
Aldi T Kraja ◽  
...  

Introduction: Adult height is inversely associated with the risk of developing hypertension, hyperlipidemia, and diabetes. Height has also shown an inverse association with coronary heart disease and cardiovascular mortality, but the relationship between height and subclinical atherosclerosis is unclear. Coronary artery calcium (CAC) is a marker of atherosclerosis and a strong predictor of cardiovascular events. The relationship between height and CAC has not been well studied. Objective: To test the hypothesis that adult height is inversely associated with CAC. Methods: We studied 3,360 individuals from the National Heart, Lung, and Blood Institute Family Heart Study. Adult height was self-reported and CAC was measured by EBCT. We used generalized estimating equations to estimate adjusted prevalence odds ratios across quintiles of height. Results: Mean age of the sample was 54.9 years (SD +/- 12.9) and 57% were women. Baseline characteristics of the participants in sex-specific quintiles are shown in Table 1. After adjusting for age, the prevalence odds ratios for CAC decreased from the lowest quintile to the highest quintile (p-value for trend 0.02). After further adjustment for race, waist circumference, smoking, and field center, height remained inversely associated with CAC (adjusted odds ratios 1.0 [reference], 1.52 [1.13-2.05], 0.98 [0.75-1.28], 0.90 [0.68-1.20], 0.78 [0.58-1.03], p-value for trend <0.01). Additional adjustment for alcohol consumption, exercise, and total cholesterol did not materially change the strength of the association between height and CAC. No interaction was seen for gender or race. Conclusion: Adult height is inversely associated with the presence of CAC in middle-aged men and women.

2019 ◽  
Vol 39 (4) ◽  
pp. 826-833 ◽  
Author(s):  
Seolhye Kim ◽  
Yoosoo Chang ◽  
Juhee Cho ◽  
Yun Soo Hong ◽  
Di Zhao ◽  
...  

Objective— We examined the association of cardiovascular health (CVH) metrics with the development and progression of coronary artery calcium (CAC) among apparently healthy adults. Approach and Results— This cohort study included 65 494 men and women 30 years of age and older free of cardiovascular disease at baseline who underwent a comprehensive exam including CAC scoring. CVH metrics were defined according to the American Heart Association Life’s Simple 7 metrics based on smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose. CVH scores range from 0 (all metrics considered unhealthy) to 7 (all metrics considered healthy). Participants were followed-up for a maximum of 6.6 years. Compared with participants with ideal CVH scores 0–1, the multivariable-adjusted difference in the change in geometric means of CAC scores over 5 years of follow-up were −0.40 (−0.62 to −0.19), −0.83 (−1.03 to −0.63), −1.06 (−1.25 to −0.86), −1.22 (−1.42 to −1.03), and −1.05 (−1.42 to −0.69) in participants with ideal CVH scores 2, 3, 4, 5, and 6–7, respectively. The inverse association between CVH scores and progression of CAC was observed both in participants with no CAC and in those with CAC detectable at baseline. Conclusions— A higher ideal CVH metrics score was strongly associated with a lower prevalence of CAC and with lower progression of CAC in males and females in a large cohort of healthy adults. Our findings suggest that maintaining a healthy life habits could help reduce the development and progression of subclinical atherosclerosis and ultimately prevent clinically cardiovascular event.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1775
Author(s):  
Yash R. Patel ◽  
Tasnim F. Imran ◽  
R. Curtis Ellison ◽  
Steven C. Hunt ◽  
John Jeffrey Carr ◽  
...  

Background: Sugar-sweetened beverage (SSB) intake is associated with higher risk of weight gain, diabetes, hypertension, cardiovascular disease, and cardiovascular mortality. However, the association of SSB with subclinical atherosclerosis in the general population is unknown. Objective: Our primary objective was to investigate the association between SSB intake and prevalence of atherosclerotic plaque in the coronary arteries in The National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Methods: We studied 1991 participants of the NHLBI Family Heart Study without known coronary heart disease. Intake of SSB was assessed through a semi-quantitative food frequency questionnaire. Coronary artery calcium (CAC) was measured by cardiac Computed Tomography (CT) and prevalent CAC was defined as an Agatston score ≥100. We used generalized estimating equations to calculate adjusted prevalence ratios of CAC. A sensitivity analysis was also performed at different ranges of cut points for CAC. Results: Mean age and body mass index (BMI) were 55.0 years and 29.5 kg/m2, respectively, and 60% were female. In analysis adjusted for age, sex, BMI, smoking, alcohol use, physical activity, energy intake, and field center, higher SSB consumption was not associated with higher prevalence of CAC [prevalence ratio (95% confidence interval) of: 1.0 (reference), 1.36 (0.70–2.63), 1.69 (0.93–3.09), 1.21 (0.69–2.12), 1.05 (0.60–1.84), and 1.58 (0.85–2.94) for SSB consumption of almost never, 1–3/month, 1/week, 2–6/week, 1/day, and ≥2/day, respectively (p for linear trend 0.32)]. In a sensitivity analysis, there was no evidence of association between SSB and prevalent CAC when different CAC cut points of 0, 50, 150, 200, and 300 were used. Conclusions: These data do not provide evidence for an association between SSB consumption and prevalent CAC in adult men and women.


Cardiology ◽  
2021 ◽  
pp. 1-6
Author(s):  
John Michael Cochran ◽  
Vincent R. Siebert ◽  
Jeffrey Bates ◽  
Djenita Butulija ◽  
Anna Kolpakchi ◽  
...  

Background: Identification and modification of cardiovascular risk factors is paramount to reducing cardiovascular disease morbidity and mortality. Hypertension is a major risk factor for cardiovascular disease, but its association with height remains largely underrecognized. Objectives: The objective of this manuscript is to review the evidence examining the association between blood pressure and human stature and to summarize the plausible pathophysiological mechanisms behind such an association. Methods: A systematic review of adult human height and its association with hypertension and coronary artery disease was undertaken. The literature evidence is summarized and tabulated, and an overview of the pathophysiological basis for this association is presented. Results: Shorter arterial lengths found in shorter individuals may predispose to hypertension in a complex hemodynamic interplay, which is explained predominantly by summated arterial wave reflections and an elevated augmentation index. Our systemic review suggests that an inverse relationship between adult height and blood pressure exists. However, differences in the studied populations and heterogeneity in the methods applied across the various studies limit the generalizability of these findings and their clinical application. Conclusion: Physiological studies and epidemiological data suggest a potential inverse association between adult height and blood pressure. Further research is required to define the relationship more clearly between adult height and blood pressure and to assess whether antihypertensive therapeutic approaches and goals should be modified according to patients’ heights.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Bhavya Varma ◽  
Oluseye Ogunmoroti ◽  
Chiadi Ndumele ◽  
Di Zhao ◽  
Moyses Szklo ◽  
...  

Background: Adipokines are secreted by adipose tissue, play a role in cardiometabolic pathways, and have differing associations with cardiovascular disease (CVD). Coronary artery calcium (CAC) and its progression indicate subclinical atherosclerosis and prognosticate CVD risk. However the association of adipokines with CAC progression is not well established. We examined the association of adipokines with the odds of a history of CAC progression in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We performed an analysis of 1,904 community dwelling adults free of clinical CVD in MESA. Participants underwent measurement of serum adipokines [leptin, resistin and adiponectin] at visits 2 or 3 (randomly assigned) and a contemporaneous cardiac CT scan at same visit. Participants also had a prior cardiac CT at visit 1, at a median of 2.4 years earlier. On both CTs, CAC was quantified by Agatston score. We defined a history of CAC progression between the CT scans at visit 1 and at visit 2 or 3 as those with >0 Agatston units of change per year (and compared to those with ≤0 units of change per year). We used logistic regression to examine the odds of having a history of CAC progression by adipokine tertiles using progressively adjusted models. Results: The mean participant age was 65 (10) years; 50% were women, 40% White, 13% Chinese, 21% Black and 26% Hispanic. The prevalences of CAC at visits 1 and 2/3 were 49% and 58%, respectively. There were 1,001 (53%) who had CAC progression between the 2 CT scans. In demographic-adjusted models (model 1, Table), higher leptin and lower adiponectin were associated with increased odds of prior CAC progression. In models fully adjusted for BMI and other CVD risk factors (model 3), only the highest tertile of leptin remained associated with a greater odds of prior CAC progression [OR 1.55 (95% CI 1.04, 2.30)]. Conclusions: Higher leptin levels were independently associated with a history of CAC progression. Atherosclerosis progression may be one mechanism through which leptin confers increased CVD risk


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Joseph Yeboah ◽  
Che L Smith ◽  
Mario Sims ◽  
Ervin Fox ◽  
Yaorong Ge ◽  
...  

Background: Prior studies suggest that African Americans (AA) have lower prevalence of coronary artery calcium (CAC) compared to whites, yet CAC has similar ability to predict coronary heart disease (CHD) events. The role of CAC as a screening tool for CHD risk in AA is unclear. We compared the diagnostic accuracy for CHD prevalence using the CAC score and the Framingham Risk Score (FRS) in an adult population of AA. Methods: CAC was measured in 2944 participants in the Jackson Heart Study, an NHLBI funded study of AA based in Jackson, MS. Approximately 8% of this cohort had known cardiovascular disease (CVD) defined as prior MI, angina, stroke, PTCA, CABG or PVD. Logistic regression, ROC and net reclassification index (NRI) analysis were used adjusting for age, gender, SBP, total and HDL cholesterol, smoking status, DM and BMI. FRS was calculated and those with DM were classified as high risk. Results: The mean age was 60, 65% were females, 26% had DM, 50% were obese and 30% were current or former smokers. Prevalent CVD was associated with older age, higher SBP, lower HDL and total cholesterol, and higher CAC. CAC was independently associated with prevalent CVD in our multivariable model [OR (95% CI): 1.26 (1.17, 1.35), p< 0.0001]. In ROC analysis, CAC improved the diagnostic accuracy (c statistic) of the FRS from 0.617 to 0.757 (p < 0.0001) for prevalent CVD. The FRS classified 30% of the cohort as high risk, 38.5% as intermediate risk and 31.5% as low risk. FRS classfied 51% of subjects with prevalent CVD as high risk. Addition of CAC to FRS resulted in net reclassification improvement of 4% for subjects with known CVD and 28.5% in those without CVD (see figure). Conclusion: In AA, the CAC is independently associated with prevalent CVD and improves the diagnostic accuracy of FRS for prevalent CVD by 14%. Addition of CAC improves the NRI of those with prevalent CVD by 4% and the NRI of individuals without CVD by 28.5%. Determination of CAC in AA may be useful in identifying individuals at risk of CVD and reclassifying individuals with low and intermediate FRS.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ramzi Dudum ◽  
Zeina A Dardari ◽  
David Feldman ◽  
Daniel Berman ◽  
Matthew J Budoff ◽  
...  

Objectives: We sought to assess characteristics of diffuse coronary artery calcium (CAC) phenotypes and their associations with cause-specific mortality. Background: CAC is a measure of subclinical atherosclerosis and improves risk stratification. CAC characteristics including vessel involvement, number of vessels, volume, and density have been shown to differentially impact risk. Less is known about clinical predictors of a diffuse CAC phenotype and its impact on cause-specific mortality. Methods: The CAC Consortium is a retrospective, multi-site cohort of 66,636 participants without CHD who underwent CAC scoring. Risk factor data were collected at enrollment or scan. Participants with CAC>0 were included—CAC area, CAC density, and the CAC index of diffusion (the percentage of total CAC in the vessel with the highest CAC score) were calculated and the association between CAC characteristics and CVD- and CHD-specific mortality was assessed. Results: In 28,147 study participants (mean age 58.3 years, 25% female, and 89.6% white), ~66% had ≥2 calcified vessels. Diabetes, hypertension, and hyperlipidemia were predictors of multivessel involvement (p<0.001). After controlling for CAC score, those with 4-vessel CAC had more CAC area involved with less dense calcification compared to those with 1-vessel involvement. After adjustment, those with CAC score 1-299 had a graded increase in CVD- and CHD-specific mortality with increasing vessel number compared with 1-vessel CAC. No difference was seen for individuals with CAC >300. Among those with multivessel CAC involvement, all-cause survival was significantly worse in diffuse compared to other phenotypes. Conclusion: Diffuse CAC involvement was characterized by less dense calcification, more CAC area, multiple coronary vessel involvement, and presence of certain traditional risk factors. Multivessel CAC is associated with increased CVD- and CHD-specific mortality, particularly among CAC scores 1-299.


2019 ◽  
Vol 15 (2) ◽  
pp. 120
Author(s):  
Rosita Kai ◽  
Bachtiar Murtala ◽  
Andi Alfian Zainuddin ◽  
Muzakkir Amin ◽  
Muhammad Ilyas

Increased serum calcium and phosphate associated with cardiovascular disease in patients with chronic kidney disease, but research on the relationship between coronary artery calcium scores with serum calcium and phosphate in individuals with normal kidney function is lacking. We explore the relationship of serum calcium and phosphate levels with coronary atherosclerosis as assessed by cardiac Multislice Computed Tomography (MSCT) in individuals with normal kidney function. This study aims to assess the correlation of calcium level scores on cardiac MSCT examination with serum calcium and phosphate levels, and assess the association with risk factors for coronary heart disease. This study was a cross-sectional study of 40 subjects who underwent cardiac MSCT examination with normal kidney function, at RSUP Dr. Wahidin Sudirohusodo Makassar during the March-July 2019 period. The results showed an correlation between coronary artery calcium scores with calcium and serum phosphate (serum calcium r = 0.67, serum phosphate r = 0.53, p <0.05).


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Sharan K Rai ◽  
Alka M Kanaya ◽  
Namratha Kandula ◽  
Qi Sun ◽  
Shilpa N Bhupathiraju

Introduction: South Asians are at a disproportionately high risk for cardiometabolic disease. The Mediterranean diet is associated with reduced risks of type 2 diabetes (T2D) and cardiovascular disease in certain populations, although data among South Asians are lacking. Therefore, we evaluated the association between a novel South Asian Mediterranean style (SAM) diet pattern and a broad panel of cardiometabolic markers from the MASALA study, an ongoing prospective cohort of South Asians in the US. Methods: We included 891 participants who completed the baseline visit (2010-13) with reliable responses to a validated ethnic-specific food frequency questionnaire (mean age 55 y; 47% female). We created the SAM score by grouping foods including those specific to this population’s cuisine into 9 pre-defined categories (vegetables, fruits, legumes, nuts, whole grains, red/processed meats, fish, alcohol, and monounsaturated to saturated fat ratio). Participants above the median intake received 1 point per category; red/processed meats were reverse scored and those with alcohol intake 5-25 g/d received 1 point. We summed these for a score from 0-9, with higher scores reflecting greater adherence to a Mediterranean style diet. Participants underwent a clinical exam, carotid ultrasound, cardiac and abdominal CT, and fasting blood tests. We used multivariable linear and logistic regression to examine cross-sectional associations between the SAM score and cardiometabolic risk, adjusting for age, sex, calories, physical activity, smoking status, medical history, income, education level, and cultural beliefs. We additionally adjusted for body mass index (BMI) in the full model. Finally, we examined the association between the SAM score and incident T2D at follow-up (~5 y later). Results: Participants with higher SAM scores tended to be older, more likely to have a bachelor’s degree, less likely to report experiences of discrimination, and less likely to be smokers. At baseline, the SAM score was inversely associated with pericardial fat volume (-1.22 ± 0.55 cm 3 per 1-unit increase in SAM score; p value=0.03) in the fully adjusted model. We observed an inverse association between the SAM score and visceral fat, but it was attenuated after additionally adjusting for BMI. There were no associations with subclinical atherosclerosis, glycemia measures, lipids, inflammatory markers, or uric acid. The SAM score was associated with a lower likelihood of obesity (odds ratio [OR] 0.88, 95% confidence interval [CI] 0.79 to 0.98) and fatty liver (OR 0.82, 95% CI 0.68 to 0.98), but not with hypertension. Finally, the SAM score was associated with lower odds of incident T2D (OR 0.75, 95% CI 0.59 to 0.95) at follow-up. Conclusion: A greater intake of a Mediterranean style diet that incorporates traditional South Asian foods was associated with favorable measures of adiposity and a lower likelihood of incident T2D.


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