title: Racial differences in the burden of coronary artery calcium and carotid intima media thickness between Blacks and Whites.
abstract: BACKGROUND
  Identification of racial differences in the burden and correlates of carotid intima media thickness (CIMT) and coronary artery calcium (CAC) may provide the basis for the development of race-specific cardiovascular disease (CVD) risk prediction algorithms.
  
  
  METHODS
  In the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study, CIMT was measured by carotid ultrasonography in 792 individuals (35 % Black). CIMT >1 mm was considered significant. CAC was quantified by electron beam computed tomography in 776 individuals (46 % Black). CAC was considered significant if the Agatston score was >100. Cross-sectional associations between race, CIMT and CAC were assessed using logistic regression models.
  
  
  RESULTS
  Blacks had greater CIMT (mean difference 0.033 mm, 95 % CI 0.005-0.06 mm; p = 0.02) and 1.5-fold (95 % CI 1.0-2.3) higher odds of having significant CIMT than Whites. Blacks had less CAC than Whites (mean Agatston score difference 66, [11-122]; p = 0.02) and 50 % lower odds of a significant CAC score compared with Whites (0.5 [0.3-0.7]). These associations were virtually unchanged after adjustment for CVD risk factors. Of the novel CVD risk markers assessed, small-dense low-density lipoprotein was independently associated with increased odds of significant CIMT, with the association being similar among Blacks and Whites (odds ratio [95 % CI]: 1.7 [1.2-2.5] and 1.4 [1.0-1.8] per 1-SD higher level, respectively). Interleukin-6 was significantly associated with CAC among Blacks (1.4 [1.0-2.0]).
  
  
  CONCLUSIONS
  Black race is independently associated with greater CIMT but less CAC than White race. CVD risk stratification strategies that incorporate these measures of subclinical atherosclerosis should consider race-specific algorithms.
authors.affiliation: Department of Medicine, Weill Cornell Medical College, 525 E 68th Street, Box 130, New York, NY, 10065, USA, see9003@med.cornell.edu.
authors.forename: S
authors.initials: S
authors.lastname: Erqou
authors.forename: K E
authors.initials: KE
authors.lastname: Kip
authors.forename: S R
authors.initials: SR
authors.lastname: Mulukutla
authors.forename: A N
authors.initials: AN
authors.lastname: Aiyer
authors.forename: S E
authors.initials: SE
authors.lastname: Reis