JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
 QUICK SEARCH:   [advanced]


     


J Am Coll Cardiol, 2007; 49:2013-2020, doi:10.1016/j.jacc.2007.03.009 (Published online 3 May 2007).
© 2007 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2007.03.009v1
49/20/2013    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (4)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Loria, C. M.
Right arrow Articles by Detrano, R.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Loria, C. M.
Right arrow Articles by Detrano, R.

CLINICAL RESEARCH: CORONARY ARTERY DISEASE

Early Adult Risk Factor Levels and Subsequent Coronary Artery Calcification

The CARDIA Study

Catherine M. Loria, PhD*,*, Kiang Liu, PhD{dagger}, Cora E. Lewis, MD, MPSPH{ddagger}, Stephen B. Hulley, MD§, Stephen Sidney, MD, MPH, Pamela J. Schreiner, PhD||, O. Dale Williams, PhD{ddagger}, Diane E. Bild, MD, MPH* and Robert Detrano, MD, PhD**

* Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
{dagger} Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
{ddagger} Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
§ Department of Epidemiology and Biostatistics, University of California, San Francisco, California
Division of Research, Kaiser Permanente, Oakland, California
|| Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
** Harbor-University of California Los Angeles Research and Education Institute, Torrance, California.

Manuscript received September 25, 2006; revised manuscript received January 19, 2007, accepted January 22, 2007.

* Reprint requests and correspondence: Dr. Catherine M. Loria, National Heart, Lung, and Blood Institute, Division of Prevention and Population Sciences, 6701 Rockledge Drive, Room 10116, Bethesda, Maryland 20892-7936. (Email: loriac{at}mail.nih.gov).

Objectives: We sought to determine whether early adult levels of cardiovascular risk factors predict subsequent coronary artery calcium (CAC) better than concurrent or average 15-year levels and independent of a 15-year change in levels.

Background: Few studies have used multiple measures over the course of time to predict subclinical atherosclerosis.

Methods: African American and white adults, ages 18 to 30 years, in 4 U.S. cities were enrolled in the prospective CARDIA (Coronary Artery Risk Development in Young Adults) study from 1985 to 1986. Risk factors were measured at years 0, 2, 5, 7, 10, and 15, and CAC was assessed at year 15 (n = 3,043).

Results: Overall, 9.6% adults had any CAC, with a greater prevalence among men than women (15.0% vs. 5.1%), white than African American men (17.6% vs. 11.3%), and ages 40 to 45 years than 33 to 39 years (13.3% vs. 5.5%). Baseline levels predicted CAC presence (C = 0.79) equally as well as average 15-year levels (C = 0.79; p = 0.8262) and better than concurrent levels (C = 0.77; p = 0.019), despite a 15-year change in risk factor levels. Multivariate-adjusted odds ratios of having CAC by ages 33 to 45 years were 1.5 (95% confidence interval [CI] 1.3 to 1.7) per 10 cigarettes, 1.5 (95% CI 1.3 to 1.8) per 30 mg/dl low-density lipoprotein cholesterol, 1.3 (95% CI 1.1 to 1.5) per 10 mm Hg systolic blood pressure, and 1.2 (95% CI 1.1 to 1.4) per 15 mg/dl glucose at baseline. Young adults with above optimal risk factor levels at baseline were 2 to 3 times as likely to have CAC.

Conclusions: Early adult levels of modifiable risk factors, albeit low, were equally or more informative about odds of CAC in middle age than subsequent levels. Earlier risk assessment and efforts to achieve and maintain optimal risk factor levels may be needed.

Abbreviations and Acronyms
  BMI = body mass index
  BP = blood pressure
  CAC = coronary artery calcium
  CI = confidence interval
  CT = computed tomography
  CVD = cardiovascular disease
  HDL-C = high-density lipoprotein cholesterol
  LDL-C = low-density lipoprotein cholesterol
  OR = odds ratio




This article has been cited by other articles:


Home page
J Am Coll CardiolHome page
A. N. DeMaria, J. J. Bax, O. Ben-Yehuda, P. Clopton, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, J. D. Knoke, W. Y.W. Lew, J. A.C. Lima, et al.
Highlights of the year in JACC 2007.
J. Am. Coll. Cardiol., January 29, 2008; 51(4): 490 - 512.
[Full Text] [PDF]


Home page
CirculationHome page
I. Tabas, K. J. Williams, and J. Boren
Subendothelial Lipoprotein Retention as the Initiating Process in Atherosclerosis: Update and Therapeutic Implications
Circulation, October 16, 2007; 116(16): 1832 - 1844.
[Abstract] [Full Text] [PDF]


Home page
DOC NewsHome page
K. Ullman
Early CV Risk Factors Predict Coronary Calcium 15 Years Later
DOC News, September 1, 2007; 4(9): 5 - 5.
[Full Text]




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2007 by the American College of Cardiology Foundation.