title: Ten-year trends in coronary calcification in individuals without clinical cardiovascular disease in the multi-ethnic study of atherosclerosis.
abstract: BACKGROUND
  Coronary heart disease (CHD) incidence has declined significantly in the US, as have levels of major coronary risk factors, including LDL-cholesterol, hypertension and smoking, but whether trends in subclinical atherosclerosis mirror these trends is not known.
  
  
  RESULTS
  To describe recent secular trends in subclinical atherosclerosis as measured by serial evaluations of coronary artery calcification (CAC) prevalence in a population over 10 years, we measured CAC using computed tomography (CT) and CHD risk factors in five serial cross-sectional samples of men and women from four race/ethnic groups, aged 55-84 and without clinical cardiovascular disease, who were members of Multi-Ethnic Study of Atherosclerosis (MESA) cohort from 2000 to 2012. Sample sizes ranged from 1062 to 4837. After adjusting for age, gender, and CT scanner, the prevalence of CAC increased across exams among African Americans, whose prevalence of CAC was 52.4% in 2000-02, 50.4% in 2003-04, 60.0% is 2005-06, 57.4% in 2007-08, and 61.3% in 2010-12 (p for trend <0.001). The trend was strongest among African Americans aged 55-64 [prevalence ratio for 2010-12 vs. 2000-02, 1.59 (95% confidence interval 1.06, 2.39); p = 0.005 for trend across exams]. There were no consistent trends in any other ethnic group. Risk factors generally improved in the cohort, and adjustment for risk factors did not change trends in CAC prevalence.
  
  
  CONCLUSIONS
  There was a significant secular trend towards increased prevalence of CAC over 10 years among African Americans and no change in three other ethnic groups. Trends did not reflect concurrent general improvement in risk factors. The trend towards a higher prevalence of CAC in African Americans suggests that CHD risk in this population is not improving relative to other groups.
authors.affiliation: Division of Cardiovascular Sciences, NHLBI, Bethesda, Maryland, United States of America.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Bild
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington, United States of America.
authors.forename: Robyn
authors.initials: R
authors.lastname: McClelland
authors.affiliation: Department of Environmental and Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, Washington, United States of America.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kaufman
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Roger
authors.initials: R
authors.lastname: Blumenthal
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
authors.forename: J Jeffrey
authors.initials: JJ
authors.lastname: Carr
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Register
authors.affiliation: Columbia University, New York, New York, United States of America.
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000208:ethnology*; D002114:Calcinosis / Q000150:complications*; D003324:Coronary Artery Disease / Q000150:complications*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000960:Hypolipidemic Agents
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