Ethnic differences of the presence and severity of coronary atherosclerosis

Matthew J. Budoff, Khurram Nasir, Songshou Mao, Philip H. Tseng, Alex Chau, Sandy T. Liu, Ferdinand Flores, Roger S Blumenthal

Research output: Contribution to journalArticle

Abstract

Background: Although cardiovascular risk factor levels are substantially different in Caucasians, African-American, Hispanics, and Asians, the relative rates of coronary heart disease in these groups are not consistent with these differences. The objective of the study is to assess the differences in the prevalence and severity of coronary artery calcification, as a measure of atherosclerosis, in these different ethnic groups. Methods: Electron-beam tomography was performed in 16,560 asymptomatic men and women (Asians = 1336, African-Americans = 610, Hispanics = 1256) aged ≥35 years referred by their physician for cardiovascular risk evaluation. The study population encompassed 70% males, aged 52 ± 8 years. Results: Caucasians were more likely to present with dyslipidemia (p <0.0001), while African-Americans and Hispanics had a higher prevalence of smoking, diabetes, and hypertension (all p <0.001). After adjustment for age, gender, risk factors, and treatment for hypercholesterolemia, compared with Caucasians, the relative risks for men having coronary calcification were 0.64 (95% CI: 0.48-0.86) in African-Americans, 0.88 (95% CI: 0.67-1.15) in Hispanics, and 0.66 (95% CI: 0.55-0.80) in Asians. After similar adjustments, the relative risks for women having coronary calcification, were 1.58 (95% CI: 1.13-2.19) for African-Americans, 0.84 (95% CI: 0.66-1.06) in Hispanics, and 0.71 (95% CI: 0.56-0.89) in Asian women. After adjusting for age and risk factors using multivariable analysis, African-American men were least likely to have any coronary calcium while African-American women had significantly higher OR of any calcification. Asian men and women had significantly lower OR of any calcification. There was no significant difference in prevalence or severity of atherosclerosis between Hispanics and Caucasians, in men or women. Conclusions: Our study results demonstrate significant difference in the presence as well as severity of calcification according to ethnicity, independent of atherosclerotic risk factors. Results from this study (physician referred) closely parallel the results from MESA (population based, measured risk factors). Ethnic specific data on the predictive value of differing coronary calcium scores are needed.

Original languageEnglish (US)
Pages (from-to)343-350
Number of pages8
JournalAtherosclerosis
Volume187
Issue number2
DOIs
StatePublished - Aug 2006

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African Americans
Coronary Artery Disease
Hispanic Americans
Atherosclerosis
Calcium
Physicians
Social Adjustment
X Ray Computed Tomography
Age Factors
Dyslipidemias
Hypercholesterolemia
Ethnic Groups
Population
Coronary Disease
Coronary Vessels
Smoking
Hypertension

Keywords

  • Coronary atherosclerosis
  • Coronary calcium
  • Electron beam tomography
  • Ethnicity
  • Racial differences

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ethnic differences of the presence and severity of coronary atherosclerosis. / Budoff, Matthew J.; Nasir, Khurram; Mao, Songshou; Tseng, Philip H.; Chau, Alex; Liu, Sandy T.; Flores, Ferdinand; Blumenthal, Roger S.

In: Atherosclerosis, Vol. 187, No. 2, 08.2006, p. 343-350.

Research output: Contribution to journalArticle

Budoff, MJ, Nasir, K, Mao, S, Tseng, PH, Chau, A, Liu, ST, Flores, F & Blumenthal, RS 2006, 'Ethnic differences of the presence and severity of coronary atherosclerosis', Atherosclerosis, vol. 187, no. 2, pp. 343-350. https://doi.org/10.1016/j.atherosclerosis.2005.09.013
Budoff, Matthew J. ; Nasir, Khurram ; Mao, Songshou ; Tseng, Philip H. ; Chau, Alex ; Liu, Sandy T. ; Flores, Ferdinand ; Blumenthal, Roger S. / Ethnic differences of the presence and severity of coronary atherosclerosis. In: Atherosclerosis. 2006 ; Vol. 187, No. 2. pp. 343-350.
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abstract = "Background: Although cardiovascular risk factor levels are substantially different in Caucasians, African-American, Hispanics, and Asians, the relative rates of coronary heart disease in these groups are not consistent with these differences. The objective of the study is to assess the differences in the prevalence and severity of coronary artery calcification, as a measure of atherosclerosis, in these different ethnic groups. Methods: Electron-beam tomography was performed in 16,560 asymptomatic men and women (Asians = 1336, African-Americans = 610, Hispanics = 1256) aged ≥35 years referred by their physician for cardiovascular risk evaluation. The study population encompassed 70{\%} males, aged 52 ± 8 years. Results: Caucasians were more likely to present with dyslipidemia (p <0.0001), while African-Americans and Hispanics had a higher prevalence of smoking, diabetes, and hypertension (all p <0.001). After adjustment for age, gender, risk factors, and treatment for hypercholesterolemia, compared with Caucasians, the relative risks for men having coronary calcification were 0.64 (95{\%} CI: 0.48-0.86) in African-Americans, 0.88 (95{\%} CI: 0.67-1.15) in Hispanics, and 0.66 (95{\%} CI: 0.55-0.80) in Asians. After similar adjustments, the relative risks for women having coronary calcification, were 1.58 (95{\%} CI: 1.13-2.19) for African-Americans, 0.84 (95{\%} CI: 0.66-1.06) in Hispanics, and 0.71 (95{\%} CI: 0.56-0.89) in Asian women. After adjusting for age and risk factors using multivariable analysis, African-American men were least likely to have any coronary calcium while African-American women had significantly higher OR of any calcification. Asian men and women had significantly lower OR of any calcification. There was no significant difference in prevalence or severity of atherosclerosis between Hispanics and Caucasians, in men or women. Conclusions: Our study results demonstrate significant difference in the presence as well as severity of calcification according to ethnicity, independent of atherosclerotic risk factors. Results from this study (physician referred) closely parallel the results from MESA (population based, measured risk factors). Ethnic specific data on the predictive value of differing coronary calcium scores are needed.",
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T1 - Ethnic differences of the presence and severity of coronary atherosclerosis

AU - Budoff, Matthew J.

AU - Nasir, Khurram

AU - Mao, Songshou

AU - Tseng, Philip H.

AU - Chau, Alex

AU - Liu, Sandy T.

AU - Flores, Ferdinand

AU - Blumenthal, Roger S

PY - 2006/8

Y1 - 2006/8

N2 - Background: Although cardiovascular risk factor levels are substantially different in Caucasians, African-American, Hispanics, and Asians, the relative rates of coronary heart disease in these groups are not consistent with these differences. The objective of the study is to assess the differences in the prevalence and severity of coronary artery calcification, as a measure of atherosclerosis, in these different ethnic groups. Methods: Electron-beam tomography was performed in 16,560 asymptomatic men and women (Asians = 1336, African-Americans = 610, Hispanics = 1256) aged ≥35 years referred by their physician for cardiovascular risk evaluation. The study population encompassed 70% males, aged 52 ± 8 years. Results: Caucasians were more likely to present with dyslipidemia (p <0.0001), while African-Americans and Hispanics had a higher prevalence of smoking, diabetes, and hypertension (all p <0.001). After adjustment for age, gender, risk factors, and treatment for hypercholesterolemia, compared with Caucasians, the relative risks for men having coronary calcification were 0.64 (95% CI: 0.48-0.86) in African-Americans, 0.88 (95% CI: 0.67-1.15) in Hispanics, and 0.66 (95% CI: 0.55-0.80) in Asians. After similar adjustments, the relative risks for women having coronary calcification, were 1.58 (95% CI: 1.13-2.19) for African-Americans, 0.84 (95% CI: 0.66-1.06) in Hispanics, and 0.71 (95% CI: 0.56-0.89) in Asian women. After adjusting for age and risk factors using multivariable analysis, African-American men were least likely to have any coronary calcium while African-American women had significantly higher OR of any calcification. Asian men and women had significantly lower OR of any calcification. There was no significant difference in prevalence or severity of atherosclerosis between Hispanics and Caucasians, in men or women. Conclusions: Our study results demonstrate significant difference in the presence as well as severity of calcification according to ethnicity, independent of atherosclerotic risk factors. Results from this study (physician referred) closely parallel the results from MESA (population based, measured risk factors). Ethnic specific data on the predictive value of differing coronary calcium scores are needed.

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KW - Coronary calcium

KW - Electron beam tomography

KW - Ethnicity

KW - Racial differences

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