Abstract 1636: The Relevance of Borderline Abnormalities in Classic Cardiac Risk Factors: Observations From the Dallas Heart Study
Background: The relevance of borderline abnormalities of classic CV risk factors (RF) remains unclear. We sought to determine the prevalence of borderline RF abnormalities and their association with atherosclerosis in a population-based study
Methods: Subjects ages 30 – 65 from the Dallas Heart Study, a multiethnic, probability-based sample, were evaluated. Blood pressure (BP), fasting glucose (FG), LDL and smoking status were categorized as optimal, borderline or elevated. Borderline RF were defined as: no therapy and
BP 120 –139 mmHg systolic or 80 – 89 diastolic mmHg;
LDL 100 –129mg/dL;
FG 100 –125mg/dL; and/or
Participants with ≥1 borderline but no elevated RF were classified as “Borderline”, and with any elevated RF as “Elevated”. Associations were assessed between RF categories and CT-detected coronary artery calcium (CAC). Prevalence data were sample-weight adjusted.
Results: Of the 2966 participants (mean age 45; 20% black, 25% Hispanic, 50% women), 41% were in the Borderline group. The prevalence of CAC was 4%, 11%, and 27% for Optimal, Borderline, and Elevated groups respectively (Figure⇓). Borderline vs. Optimal status was associated with a higher adjusted odds of CAC (OR=2.6, 95% CI 1.2– 5.9). Within each subcategory of elevated RF (ie:1, 2, or 3 elevated), there was a graded increase in prevalent CAC with increasing number of borderline RF (p trend <0.05 each). Twelve % of the population burden of CAC was attributable to Borderline RFs.
Conclusions: Borderline RFs are common and are associated with coronary atherosclerosis among individuals with and without elevated RFs. Targeting borderline RF may help to reduce the burden of atherosclerosis.