title: Sex differences in subclinical atherosclerosis by race/ethnicity in the multi-ethnic study of atherosclerosis.
abstract: Sex differences in cardiovascular disease mortality are more pronounced among non-Hispanic whites than other racial/ethnic groups, but it is unknown whether this variation is present in the earlier subclinical stages of disease. The authors examined racial/ethnic variation in sex differences in coronary artery calcification (CAC) and carotid intimal media thickness at baseline in 2000-2002 among participants (n = 6,726) in the Multi-Ethnic Study of Atherosclerosis using binomial and linear regression. Models adjusted for risk factors in several stages: age, traditional cardiovascular disease risk factors, behavioral risk factors, psychosocial factors, and adult socioeconomic position. Women had a lower prevalence of any CAC and smaller amounts of CAC when present than men in all racial/ethnic groups. Sex differences in the prevalence of CAC were more pronounced in non-Hispanic whites than in African Americans and Chinese Americans after adjustment for traditional cardiovascular disease risk factors, and further adjustment for behavioral factors, psychosocial factors, and socioeconomic position did not modify these results (for race/sex, P(interaction) = 0.047). Similar patterns were observed for amount of CAC among adults with CAC. Racial/ethnic variation in sex differences for carotid intimal media thickness was less pronounced. In conclusion, coronary artery calcification is differentially patterned by sex across racial/ethnic groups.
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, USA. cathkim@umich.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Kim
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez-Roux
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Nettleton
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: Karol E
authors.initials: KE
authors.lastname: Watson
authors.forename: Anjel M
authors.initials: AM
authors.lastname: Vahratian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000453:epidemiology / Q000208:ethnology*; D002114:Calcinosis / Q000453:epidemiology / Q000208:ethnology*; D002339:Carotid Arteries; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D017539:Tunica Intima / Q000473:pathology*