scholarly journals Association of Carotid Artery Plaque With Cardiovascular Events and Incident Coronary Artery Calcium in Individuals With Absent Coronary Calcification

2021 ◽  
Author(s):  
Anurag Mehta ◽  
Joseph Rigdon ◽  
Matthew C. Tattersall ◽  
Charles A. German ◽  
Thomas A. Barringer ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Carotid Plaque ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Carotid Artery Plaque ◽  
Plaque Score ◽  
Asymptomatic Individuals ◽  
Heart Disease Risk

Background: Absence of coronary artery calcium (CAC) identifies asymptomatic individuals at low cardiovascular disease risk. Carotid artery plaque is a marker of increased risk, but its association with cardiovascular risk and incident CAC in people without CAC is unclear. Methods: Multi-Ethnic Study of Atherosclerosis participants with CAC score of 0 at enrollment who also underwent carotid plaque measurement using B-mode ultrasonography were prospectively followed for incident coronary heart disease, stroke, and cardiovascular disease events, and CAC (score >0 on up to 3 serial computed tomography scans). The association of carotid plaque presence and plaque score (Ln[score+1]) at baseline with cardiovascular events and incident CAC was evaluated with Cox proportional hazards regression models adjusted for demographics, risk factors, and statin use. Results: Among these 2673 participants (58 years, 64% women, 34% White, 30% Black, 24% Hispanic, and 12% Chinese), carotid plaque at baseline was observed in 973 (36%) and the median plaque score (range, 1–12) among those with plaque was 1. A total of 79 coronary heart disease, 80 stroke, and 151 cardiovascular disease events were observed during 16.1 years of follow-up. Carotid plaque presence and plaque score were independently associated with coronary heart disease risk (HRs, 1.66 [95% CI, 1.04–2.66]; and 1.48 [95% CI, 1.01–2.17], respectively) but not with stroke and cardiovascular disease risk. A total of 973 (36.4%) participants developed CAC over the evaluation period (median 9.3 years). Carotid plaque presence and plaque score were independently associated with incident CAC (HRs, 1.34 [95% CI, 1.18–1.54]; and 1.37 [95% CI, 1.21–1.54]), respectively. Conclusions: The presence and extent of carotid plaque are associated with long-term coronary heart disease risk and incident CAC among middle-aged asymptomatic individuals with an initial CAC score of 0.

scholarly journals Sexual Assault and Carotid Plaque Among Midlife Women

2021 ◽  
Vol 10 (5) ◽  
Author(s):  
Rebecca C. Thurston ◽  
Karen Jakubowski ◽  
Yuefang Chang ◽  
Karestan Koenen ◽  
Pauline M. Maki ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Sexual Assault ◽  
Carotid Plaque ◽  
Carotid Atherosclerosis ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Linear Regression Models ◽  
Post Traumatic Stress ◽  
Plaque Score ◽  
Post Traumatic

Background Sexual assault is a risk factor for poor mental health, yet its relationship to cardiovascular disease risk is not understood. We tested whether women with a sexual assault history had greater carotid atherosclerosis levels and progression over midlife. Methods and Results A total of 169 non‐smoking, cardiovascular disease‐free women aged 40 to 60 years were assessed twice over 5 years. At each point, women completed questionnaires, physical measures, phlebotomy, and carotid ultrasounds. Associations between sexual assault and carotid plaque level (score 0, 1, ≥2) and progression (score change) were assessed in multinomial logistic and linear regression models, adjusted for age, race/ethnicity, education, body mass index, blood pressure, lipids, insulin resistance, and additionally depression/post‐traumatic stress symptoms; 28% of the women reported a sexual assault history. Relative to non‐exposed women, women with a sexual assault history had an over 4‐fold odds of a plaque score of ≥2 at baseline (≥2, odds ratio [OR] [95% CI]=4.35 [1.48–12.79], P =0.008; 1, OR [95% CI]=0.49 [0.12–1.97], P =0.32, versus no plaque; multivariable); and an over 3‐fold odds of plaque ≥2 at follow‐up (≥2, OR [95% CI]=3.65 [1.40–9.51], P =0.008; 1, OR [95% CI]=1.52 [0.46–4.99], P =0.49, versus no plaque; multivariable). Women with a sexual assault history also had an over 3‐folds greater odds of a plaque score progression of ≥2 (OR [95% CI]=3.48[1.11–10.93], P =0.033, multivariable). Neither depression nor post‐traumatic symptoms were related to plaque. Conclusions Sexual assault is associated with greater carotid atherosclerosis level and progression over midlife. Associations were not explained by standard cardiovascular disease risk factors. Future work should consider whether sexual assault prevention reduces women's cardiovascular disease risk.

scholarly journals Future Cardiovascular Disease Risk for Women With Gestational Hypertension: A Systematic Review and Meta‐Analysis

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Charmaine Chu Wen Lo ◽  
Andre C. Q. Lo ◽  
Shu Hui Leow ◽  
Grace Fisher ◽  
Beth Corker ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Events ◽  
Disease Risk ◽  
Gestational Hypertension ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Unique Identifier

Background Inconsistent findings have been found among studies evaluating the risk of cardiovascular disease for women who have had pregnancies complicated by gestational hypertension (the new onset of high blood pressure without proteinuria during pregnancy). We provide a comprehensive review of studies to quantify the association between gestational hypertension and cardiovascular events in women. Methods and Results We conducted a systematic search of PubMed, Embase, and Web of Science in March 2019 for studies examining the association between gestational hypertension and any cardiovascular event. Two reviewers independently assessed the abstracts and full‐text articles. Study characteristics and the relative risk (RR) of cardiovascular events associated with gestational hypertension were extracted from the eligible studies. Where appropriate, the estimates were pooled with inverse variance weighted random‐effects meta‐analysis. A total of 21 studies involving 3 60 1192 women (127 913 with gestational hypertension) were identified. Gestational hypertension in the first pregnancy was associated with a greater risk of overall cardiovascular disease (RR, 1.45; 95% CI, 1.17–1.80) and coronary heart disease (RR, 1.46; 95% CI, 1.23–1.73), but not stroke (RR, 1.26; 95% CI, 0.96–1.65) or thromboembolic events (RR, 0.88; 95% CI, 0.73–1.07). Women with 1 or more pregnancies affected by gestational hypertension were at greater risk of cardiovascular disease (RR, 1.81; 95% CI, 1.42–2.31), coronary heart disease (RR, 1.83; 95% CI, 1.33–2.51), and heart failure (RR, 1.77; 95% CI, 1.47–2.13), but not stroke (RR, 1.50; 95% CI, 0.75–2.99). Conclusions Gestational hypertension is associated with a greater risk of overall cardiovascular disease, coronary heart disease, and heart failure. More research is needed to assess the presence of a dose–response relationship between gestational hypertension and subsequent cardiovascular disease. Registration URL: https://www.crd.york.ac.uk/prosp​ero/ ; Unique identifier: CRD 42018119031.

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