TY - JOUR
T1 - A synergistic relationship of elevated low-density lipoprotein cholesterol levels and systolic blood pressure with coronary artery calcification
AU - Musunuru, Kiran
AU - Nasir, Khurram
AU - Pandey, Shivda
AU - Campbell, Catherine C.
AU - Carvalho, Jose A.M.
AU - Meneghello, Romeu
AU - Budoff, Matthew J.
AU - Blumenthal, Roger S.
AU - Santos, Raul D.
PY - 2008/10
Y1 - 2008/10
N2 - We sought to evaluate this "response-to-injury" hypothesis of atherosclerosis by studying the interaction between systolic blood pressure (SBP) and LDL- cholesterol (LDL-C) in predicting the presence of coronary artery calcification (CAC) in asymptomatic men. We studied 526 men (46 ± 7 years of age) referred for electron-beam tomography (EBT) exam. The prevalence of CAC was determined across LDL-C tertiles (low: <115 mg/dl; middle: 115-139 mg/dl; high: ≥140 mg/dl) within tertiles of SBP (low: <121 mmHg; middle: 121-130 mmHg; high: ≥131 mmHg). CAC was found in 220 (42%) men. There was no linear trend in the presence of CAC across LDL-C tertiles in the low (p = 0.6 for trend) and middle (p = 0.3 for trend) SBP tertile groups, respectively. In contrast, there was a significant trend for increasing CAC with increasing LDL-C (1st: 44%; 2nd: 49%; 3rd: 83%; p < 0.0001 for trend) in the high SBP tertile group. In multivariate logistic analyses (adjusting for age, smoking, triglyceride levels, HDL-cholesterol levels, body mass index, and fasting glucose levels), the odds ratio for any CAC associated with increasing LDL-C was significantly higher in those with highest SBP levels, whereas no such relationship was observed among men with SBP in the lower two tertiles. An interaction term (LDL-C × SBP) incorporated in the multivariate analyses was statistically significant (p = 0.038). The finding of an interaction between SBP and LDL-C relation to CAC in asymptomatic men support the response-to-injury model of atherogenesis.
AB - We sought to evaluate this "response-to-injury" hypothesis of atherosclerosis by studying the interaction between systolic blood pressure (SBP) and LDL- cholesterol (LDL-C) in predicting the presence of coronary artery calcification (CAC) in asymptomatic men. We studied 526 men (46 ± 7 years of age) referred for electron-beam tomography (EBT) exam. The prevalence of CAC was determined across LDL-C tertiles (low: <115 mg/dl; middle: 115-139 mg/dl; high: ≥140 mg/dl) within tertiles of SBP (low: <121 mmHg; middle: 121-130 mmHg; high: ≥131 mmHg). CAC was found in 220 (42%) men. There was no linear trend in the presence of CAC across LDL-C tertiles in the low (p = 0.6 for trend) and middle (p = 0.3 for trend) SBP tertile groups, respectively. In contrast, there was a significant trend for increasing CAC with increasing LDL-C (1st: 44%; 2nd: 49%; 3rd: 83%; p < 0.0001 for trend) in the high SBP tertile group. In multivariate logistic analyses (adjusting for age, smoking, triglyceride levels, HDL-cholesterol levels, body mass index, and fasting glucose levels), the odds ratio for any CAC associated with increasing LDL-C was significantly higher in those with highest SBP levels, whereas no such relationship was observed among men with SBP in the lower two tertiles. An interaction term (LDL-C × SBP) incorporated in the multivariate analyses was statistically significant (p = 0.038). The finding of an interaction between SBP and LDL-C relation to CAC in asymptomatic men support the response-to-injury model of atherogenesis.
KW - Coronary calcification
KW - Electron beam tomography
KW - LDL-cholesterol
KW - Risk factors
KW - Subclinical atherosclerosis
KW - Systolic blood pressure
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U2 - 10.1016/j.atherosclerosis.2007.12.015
DO - 10.1016/j.atherosclerosis.2007.12.015
M3 - Article
C2 - 18243213
AN - SCOPUS:52049085978
SN - 0021-9150
VL - 200
SP - 368
EP - 373
JO - Atherosclerosis
JF - Atherosclerosis
IS - 2
ER -