Premenopausal risk factors for coronary and aortic calcification: a 20-year follow-up in the healthy women study.
OBJECTIVE
It is important to understand the early development of subclinical cardiovascular disease (CVD) in women to prevent costly morbidity and mortality associated with CVD events.


METHODS
363 Women enrolled in the Healthy Women Study, Allegheny County, PA, had electron beam tomography measures of coronary (CaC) and aortic (AC) calcification on average 14.6 years after study entry in 1983; 267 had a second EBT 6.4 years later, by 2006. Risk factors were assessed when women were premenopausal and 5 years after the menopause.


RESULTS
Step-wise logistic regression analyses showed that the independent premenopausal predictors of CaC > or = 100 14.6 years later were low-density lipoprotein cholesterol, OR=1.15 (1.03-1.29 for 10 mg/dl) and current smoker, OR=2.72, 1.29-5.71. The same premenopausal risk factors were predictors of AC > or = 500, in addition to premenopausal systolic blood pressure (SBP). Similar results were obtained for predicting calcification 20.6 years later. Postmenopausal risk factors measured 5 years prior to the initial scans were unrelated to CaC and AC, after the significant premenopausal risk factors were taken into account, except for postmenopausal SBP being related to AC.


CONCLUSIONS
Premenopausal risk factors are strong predictors of postmenopausal CaC and AC. Clinical trials should test if reduction of premenopausal levels of risk factors reduces the risk of early calcification.
Matthews
Karen A
KA
University of Pittsburgh, Department of Psychiatry, Epidemiology and Psychology, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. matthewska@upmc.edu
Kuller
Lewis H
LH
Chang
Yuefang
Y
Edmundowicz
Daniel
D
D001018:Aortic Diseases / Q000453:epidemiology*; D001794:Blood Pressure; D002114:Calcinosis / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D017697:Premenopause; D012307:Risk Factors; D013997:Time Factors
Arterioscler Thromb Vasc Biol. 2000 Aug;20(8):1998-2004
10938023
JAMA. 2004 Oct 6;292(13):1588-92
15467061
Clin Chem. 1973 May;19(5):476-82
4703655
Clin Chem. 1974 Apr;20(4):470-5
4818200
J Lipid Res. 1978 Jan;19(1):65-76
202660
Prev Med. 1982 Mar;11(2):162-72
7088904
J Lipid Res. 1982 Nov;23(8):1206-23
7175378
Control Clin Trials. 1986 Sep;7(3 Suppl):137S-57S
3802839
Am J Epidemiol. 1989 Jun;129(6):1132-44
2729252
N Engl J Med. 1989 Sep 7;321(10):641-6
2488072
J Am Coll Cardiol. 1990 Mar 15;15(4):827-32
2407762
J Am Coll Cardiol. 1996 Feb;27(2):277-84
8557894
J Clin Epidemiol. 1996 Mar;49(3):383-7
8676189
Arterioscler Thromb Vasc Biol. 1999 Sep;19(9):2189-98
10479662
J Am Coll Cardiol. 1999 Oct;34(4):1348-59
10520820
Lancet. 1963 Dec 7;2(7319):1205
14072946
Diabetologia. 2005 Feb;48(2):379-85
15688207
J Am Coll Cardiol. 2005 Sep 6;46(5):807-14
16139129
JAMA. 2006 Apr 5;295(13):1556-65
16533939
Circulation. 2006 Oct 17;114(16):1761-91
17015792
Circulation. 2007 Apr 10;115(14):1851-7
17389269
J Am Coll Cardiol. 2005 Jul 5;46(1):158-65
15992651
Am J Cardiol. 2001 Mar 1;87(5):560-4
11230839
Arterioscler Thromb Vasc Biol. 2001 May;21(5):852-7
11348886
Am J Cardiol. 2001 Jun 15;87(12):1335-9
11397349
Stroke. 2001 May;32(5):1104-11
11340217
Arterioscler Thromb Vasc Biol. 2002 Mar 1;22(3):424-30
11884285
JAMA. 2004 May 12;291(18):2243-52
15138247
Arterioscler Thromb Vasc Biol. 2004 Jul;24(7):1272-7
15059806
Am J Cardiol. 2004 Aug 1;94(3):367-9
15276108
Clin Chem. 1972 Jun;18(6):499-502
4337382