Abstract 9110: Does Change in Cardiometabolic Risk Factors Relate to Change in Coronary Artery Calcification? Findings from the Multi-Ethnic Study of Atherosclerosis (MESA)
How CVD risk factors impact coronary artery calcification (CAC) remains unclear. Particularly lacking are data describing how change in various risk factor levels relate to change in CAC, which may lead to a greater understanding of these relationships and further inform optimal strategies for CVD prevention and treatment. With data from a multi-ethnic cohort of 4,560 individuals (46.8% men; age M = 61.35) initially free of clinical CVD, this study used latent growth modeling to examine change in specific cardiometabolic risk factors (CRFs; waist circumference, BMI, SBP, DBP, HDL and LDL cholesterol, triglycerides, and fasting glucose) related to change in CAC over an average 4.9 year time period. Data were adjusted for baseline CRF and CAC values, age, race/ethnicity, smoking, family history of CVD, income, and use of antihypertensive, lipid-lowering, and glucose-lowering medications. Men and women were analyzed separately given previously noted differences in clinical CVD development and predictive utility of CRFs. Change in CRFs was not associated with incident CAC among men and women who had undetectable CAC at baseline, or with CAC progression among men who had detectable CAC at baseline. Among women who had detectable CAC at baseline (M = 180.5, SD = 32.4 Agatston units), greater decline (or less progression) in SBP (B = -3.17, p < .05) and DBP (B = -8.56, p < .05), and LDL cholesterol (B = -2.49, p < .05), were each individually associated with greater CAC progression. The associations between change in blood pressure and CAC progression were not independent of change in LDL cholesterol. Medication use appeared to influence these inverse associations, such that women taking antihypertensive and lipid-lowering medications exhibited greater CAC progression despite showing average decreases in respective CRF levels over time. Women not taking such medications did not show these inverse associations. To our knowledge, this is the first study systematically reporting on rates of change in various CRFs related to CAC incidence and progression. Observed inverse associations appear to have been driven by women receiving medications that lowered their initially high risk factor levels but not their increased rate of CAC progression.
- © 2011 by American Heart Association, Inc.