Relationship of change in traditional cardiometabolic risk factors to change in coronary artery calcification among individuals with detectable subclinical atherosclerosis: The multi-ethnic study of atherosclerosis

William Arguelles, Maria M. Llabre, Frank J. Penedo, Martha L. Daviglus, Ralph L. Sacco, Kiang Liu, Moyses Szklo, Joseph F. Polak, John Eng, Gregory L. Burke, Neil Schneiderman

Research output: Contribution to journalArticle

Abstract

Background/Objectives Data describing relationships between change in risk factors and coronary artery calcification (CAC) are lacking and could inform optimal cardiovascular disease prevention and treatment strategies. This study aimed to examine how change in traditional cardiometabolic risk factors related to change in CAC among individuals with detectable subclinical atherosclerosis. Methods Latent growth modeling was used to examine change in cardiometabolic risk factors (waist circumference, body mass index, systolic and diastolic blood pressure, high- and low-density lipoprotein cholesterol, triglycerides, and glucose) related to change in CAC up to an average 4.9-year follow-up in a multi-ethnic cohort of 3398 asymptomatic individuals (57.8% men) who had detectable CAC (score > 0) at baseline, adjusting for baseline risk factor levels and CAC values, age, gender, race/ethnicity, smoking, family history of CVD, income, and use of antihypertensive, lipid-lowering, and glucose-lowering medications. Results Greater declines in blood pressure (systolic and diastolic) and low-density lipoprotein cholesterol at follow-up were each associated with greater CAC progression. The observed inverse associations were attributable to greater CAC progression in participants taking antihypertensive and lipid-lowering drugs who, as expected, had declines in blood pressure and lipid levels, respectively. These inverse associations did not emerge in participants not taking these medications. Conclusions Among individuals with subclinical atherosclerosis, the unexpected inverse associations observed between change in blood pressure and lipid levels with CAC progression emphasize the importance of considering medication use, and, when feasible, the severity and duration of disease, in exploring associations between risk factors and CAC change.

Original languageEnglish (US)
Pages (from-to)51-56
Number of pages6
JournalInternational Journal of Cardiology
Volume174
Issue number1
DOIs
StatePublished - Jun 1 2014

Keywords

  • Atherosclerosis
  • Coronary artery calcification
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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