title: The association between epicardial fat thickness and coronary artery calcification according to blood pressure status in nonhypertensive individuals: From the CAESAR study.
abstract: BACKGROUND
  Epicardial adipose tissue represents visceral adiposity, and the coronary artery calcium (CAC) score (CACS) has been suggested as a reasonable surrogate for coronary atherosclerosis. Epicardial fat thickness (EFT) and blood pressure status can be attributed to coronary artery calcification.
  
  
  OBJECTIVE
  The present study was performed to evaluate the association between EFT and coronary artery calcification according to blood pressure status in nonhypertensive individuals.
  
  
  METHODS
  The CACS and echocardiographic EFT measurement were performed in a total of 1878 nonhypertensive individuals (1535 men; mean age, 44 ± 8.3 years). Subjects were divided into quartiles according to EFT (≤2.575, 2.576-3.168, 3.169-3.900, and >3.900 mm) and into 2 groups according to the presence of CAC. Additionally, individuals were classified as normotensive (n = 1064) or prehypertensive (n = 814).
  
  
  RESULTS
  The prevalence of CACS >0 group in prehypertensive individuals was 6.1%, 18.1%, 22.6%, and 29.9% in the lowest, second, third, and highest EFT quartiles, respectively (P < .001) and 7.3%, 13.1%, 14.0%, and 13.9% in the normotensive group (P = .050). On multivariate regression analysis, the second, third, and highest quartile EFT groups had higher odds ratios for the presence of CAC than that of the lowest quartile (odds ratio [95% confidence interval], 3.849 [1.215-12.194], 4.069 [1.235-13.412], and 4.383 [1.385-13.875], respectively), although only in prehypertensive individuals. Moreover, an increased absolute EFT level was also associated with increased CACS in prehypertensive individuals (standardized β = 0.101, P = .035).
  
  
  CONCLUSIONS
  This study showed an independent relationship between EFT and coronary artery calcification in nonhypertensive individuals, with variable differences in this association according to blood pressure status.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Min Seok
authors.initials: MS
authors.lastname: So
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: bjjake.kim@samsung.com.
authors.forename: Byung Jin
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jung Gyu
authors.initials: JG
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Ki Chul
authors.initials: KC
authors.lastname: Sung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Bum Soo
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Kang
mesh_terms: D000273:Adipose Tissue / Q000473:pathology / Q000503:physiopathology; D000368:Aged; D001794:Blood Pressure; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000473:pathology / Q000503:physiopathology; D012042:Registries; D061205:Vascular Calcification / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology
keywords: Computed tomography; Coronary artery calcification; Coronary calcium score; Echocardiography; Epicardial adipose tissue; Epicardial fat; Epidemiology; Prehypertension