Prevalence and Correlates of Coronary Calcification in Black and White Young Adults: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

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 mm2 in area and >130 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 (P =0.04 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 P <0.05). 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.

[1]  L. Bielak,et al.  Association of Fibrinogen With Quantity of Coronary Artery Calcification Measured by Electron Beam Computed Tomography , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[2]  J. Strong,et al.  Association of Coronary Heart Disease Risk Factors with microscopic qualities of coronary atherosclerosis in youth. , 2000, Circulation.

[3]  B. Sternfeld,et al.  Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. , 2000, JAMA.

[4]  K. Matthews,et al.  Association of hostility with coronary artery calcification in young adults: the CARDIA study. Coronary Artery Risk Development in Young Adults. , 2000, JAMA.

[5]  T. Callister,et al.  Identification of patients at increased risk of first unheralded acute myocardial infarction by electron-beam computed tomography. , 2000, Circulation.

[6]  J F Cornhill,et al.  Prevalence and extent of atherosclerosis in adolescents and young adults: implications for prevention from the Pathobiological Determinants of Atherosclerosis in Youth Study. , 1999, JAMA.

[7]  R. Detrano,et al.  Ethnic origin and serum levels of 1alpha,25-dihydroxyvitamin D3 are independent predictors of coronary calcium mass measured by electron-beam computed tomography. , 1997, Circulation.

[8]  R. Gillum,et al.  Coronary Heart Disease Incidence and Survival in African-American Women and Men: The NHANES I Epidemiologic Follow-up Study , 1997, Annals of Internal Medicine.

[9]  S. Wassertheil-Smoller,et al.  Racial variation in the use of coronary-revascularization procedures. , 1997, The New England journal of medicine.

[10]  R. Sacco,et al.  Race-ethnicity and determinants of carotid atherosclerosis in a multiethnic population. The Northern Manhattan Stroke Study. , 1997, Stroke.

[11]  R. Califf,et al.  Racial variation in the use of coronary-revascularization procedures. Are the differences real? Do they matter? , 1997, The New England journal of medicine.

[12]  E. Wijsman,et al.  Differences in Lp[a] concentrations and apo[a] polymorphs between black and white Americans. , 1996, Journal of lipid research.

[13]  L. Bielak,et al.  Potential of quantity of coronary artery calcification to identify new risk factors for asymptomatic atherosclerosis. , 1996, American journal of epidemiology.

[14]  Y. Arad,et al.  Predictive value of electron beam computed tomography of the coronary arteries. 19-month follow-up of 1173 asymptomatic subjects. , 1996, Circulation.

[15]  M. Budoff,et al.  Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: a multicenter study. , 1996, Circulation.

[16]  M. Budoff,et al.  Prognostic value of coronary calcification and angiographic stenoses in patients undergoing coronary angiography. , 1996, Journal of the American College of Cardiology.

[17]  B. Thompson,et al.  Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. , 1996, Journal of the American College of Cardiology.

[18]  J. Rumberger,et al.  Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. , 1995, Circulation.

[19]  N. Powe,et al.  Black-white differences in subclinical cardiovascular disease among older adults: The cardiovascular health study , 1995 .

[20]  P Whelton,et al.  Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. , 1995, Hypertension.

[21]  R. Detrano,et al.  Racial differences in coronary calcium prevalence among high-risk adults. , 1995, The American journal of cardiology.

[22]  C H McCollough,et al.  Small lesions in the heart identified at electron beam CT: calcification or noise? , 1994, Radiology.

[23]  R. Detrano,et al.  Coronary calcium and atherosclerosis by ultrafast computed tomography in asymptomatic men and women: relation to age and risk factors. , 1994, American heart journal.

[24]  P. Sheedy,et al.  Detection of heart calcification with electron beam CT: interobserver and intraobserver reliability for scoring quantification. , 1994, Radiology.

[25]  Gerardo Heiss,et al.  Carotid Artery Intimal‐Medial Thickness Distribution in General Populations As Evaluated by B‐Mode Ultrasound , 1993, Stroke.

[26]  A. Folsom,et al.  Implications of obesity for cardiovascular disease in blacks: the CARDIA and ARIC studies. , 1991, The American journal of clinical nutrition.

[27]  L. Kuller,et al.  Validation of reported myocardial infarction mortality in blacks and whites. A report from the Community Cardiovascular Surveillance Program. , 1990, Annals of epidemiology.

[28]  R. Detrano,et al.  Quantification of coronary artery calcium using ultrafast computed tomography. , 1990, Journal of the American College of Cardiology.

[29]  D. Jacobs,et al.  Validity and Reliability of Short Physical Activity History: Cardia and the Minnesota Heart Health Program. , 1989, Journal of cardiopulmonary rehabilitation.

[30]  A. Epstein,et al.  Racial inequalities in the use of procedures for patients with ischemic heart disease in Massachusetts. , 1989, JAMA.

[31]  J. Strong,et al.  Black-white differences in aortic fatty streaks in adolescence and early adulthood: the Bogalusa Heart Study. , 1988, Circulation.

[32]  P. Bennett,et al.  Prevalence of Diabetes and Impaired Glucose Tolerance and Plasma Glucose Levels in U.S. Population Aged 20–74 Yr , 1987, Diabetes.

[33]  L. Wilkins.  Hypertension prevalence and the status of awareness, treatment, and control in the United States. Final report of the Subcommittee on Definition and Prevalence of the 1984 Joint National Committee. , 1985, Hypertension.

[34]  R. Gillum.  Coronary heart disease in black populations. I. Mortality and morbidity. , 1982, American heart journal.

[35]  J. Albers,et al.  Dextran sulfate-Mg2+ precipitation procedure for quantitation of high-density-lipoprotein cholesterol. , 1982, Clinical chemistry.

[36]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[37]  C. Sampson.  The geographic pathology of atherosclerosis. , 1969, Nutrition reviews.

[38]  P. Udani,et al.  Morbidity and mortality. , 1962, The Indian journal of child health.

[39]  David H. Blankenhorn,et al.  CORONARY ARTERIAL CALCIFICATION A REVIEW , 1961 .

[40]  P. Peyser.  Genetic epidemiology of coronary artery disease. , 1997, Epidemiologic reviews.

[41]  P. Savage,et al.  Blood pressure in young blacks and whites: relevance of obesity and lifestyle factors in determining differences. The CARDIA Study. Coronary Artery Risk Development in Young Adults. , 1996, Circulation.

[42]  N. Powe,et al.  Black-white differences in subclinical cardiovascular disease among older adults: the Cardiovascular Health Study. CHS Collaborative Research Group. , 1995, Journal of clinical epidemiology.

[43]  A. Dyer,et al.  Alcohol intake and blood pressure in young adults: the CARDIA Study. , 1990, Journal of clinical epidemiology.

[44]  S B Hulley,et al.  CARDIA: study design, recruitment, and some characteristics of the examined subjects. , 1988, Journal of clinical epidemiology.

[45]  G. Warnick.  Enzymatic methods for quantification of lipoprotein lipids. , 1986, Methods in enzymology.

[46]  Warnick Gr.  Enzymatic methods for quantification of lipoprotein lipids. , 1986 .