title: Elevated pulse wave velocity increases the odds of coronary calcification in overweight postmenopausal women.
abstract: BACKGROUND
  Aortic stiffness, assessed using carotid-femoral pulse wave velocity (cfPWV), predicts all-cause and cardiovascular mortality. Brachial-ankle pulse wave velocity index (baPVI) is a newer measure of arterial stiffness obtained using an automated system. Our aim is to evaluate the association between both these measures of arterial stiffness and coronary calcification (CAC), in overweight/obese postmenopausal women, without apparent cardiovascular disease.
  
  
  METHODS
  The CAC was assessed using electron beam tomography in 504 postmenopausal women, aged 52 to 62 years (88.2% white) with mean body mass index (BMI) 30.8 kg/m(2). The CAC scores were analyzed as CAC >0 and CAC >100 versus CAC = 0, or as ln (CAC + 1).
  
  
  RESULTS
  The cfPWV was available in 476 women (mean [SD]: 900 (255) cm/sec) and baPVI was available in 441 women (mean [SD]: 1434 (231) cm/sec. Any CAC (CAC >0) was present in approximately 51% of the cohort. Both high cfPWV (RR = 1.5, 1.6, and 1.7 for quartiles 2, 3, and 4 v 1) and baPVI (RR = 2.9, 3.7. and 4.0 for quartiles 2, 3, and 4 v 1) were associated with the presence of calcification (CAC >0). The association was attenuated but remained significant only for baPVI after adjusting for age, systolic blood pressure, average waist circumference, BMI, fasting glucose, insulin, lipids, hormone replacement therapy, and smoking status. High odds of severe calcification (CAC >100) was seen with the highest quartile of the cfPWV (RR = 5.3) and baPVI (RR = 7.8), and these associations remained significant in multivariable analysis.
  
  
  CONCLUSIONS
  Both cfPWV and baPVI are associated with presence and severity of coronary calcification in overweight postmenopausal women.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Venkitachalam
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Mackey
authors.forename: Kim
authors.initials: K
authors.lastname: Sutton-Tyrrell
authors.forename: Ami S
authors.initials: AS
authors.lastname: Patel
authors.forename: Miriam A
authors.initials: MA
authors.lastname: Boraz
authors.forename: Laurey R
authors.initials: LR
authors.lastname: Simkin-Silverman
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology; D015992:Body Mass Index; D002114:Calcinosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003331:Coronary Vessels; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D050177:Overweight; D017698:Postmenopause; D011674:Pulse; D014057:Tomography, X-Ray Computed