Associations of cardiovascular disease risk factors with abdominal aortic calcium volume and density: The Multi-Ethnic Study of Atherosclerosis (MESA).
Abdominal aortic calcium (AAC) predicts future cardiovascular disease (CVD) events and all-cause mortality independent of CVD risk factors. The standard AAC score, the Agatston, up-weights for greater calcium density, and thus models higher calcium density as associated with increased CVD risk. We determined associations of CVD risk factors with AAC volume and density (separately).



In a multi-ethnic cohort of community living adults, we used abdominal computed tomography scans to measure AAC volume and density. Multivariable linear regression was used to determine the period cross-sectional independent associations of CVD risk factors with AAC volume and AAC density in participants with prevalent AAC.



Among 1413 participants with non-zero AAC scores, the mean age was 65 ± 9 years, 52% were men, 44% were European-, 24% were Hispanic-, 18% were African-, and 14% were Chinese Americans (EA, HA, AA, and CA respectively). Median (interquartile range, IQR) for AAC volume was 628 mm3(157-1939 mm3), and mean AAC density was 3.0 ± 0.6. Compared to EA, each of HA, AA, and CA had lower natural log (ln) AAC volume, but higher AAC density. After adjustments for AAC density, older age, ever smoking history, higher systolic blood pressure, elevated total cholesterol, reduced HDL cholesterol, statin and anti-hypertensive medication use, family history of myocardial infarction, and alcohol consumption were significantly associated with higher ln(AAC volume). In contrast, after adjustments for ln(AAC volume), older age, ever smoking history, higher BMI, and lower HDL cholesterol were significantly associated with lower AAC density.



Several CVD risk factors were associated with higher AAC volume, but lower AAC density. Future studies should investigate the impact of calcium density of aortic plaques in CVD.
University of California, San Diego, Dept. of Family Medicine and Public Health, La Jolla, CA, USA. Electronic address: nforbang@gmail.com.
Nketi I
NI
Forbang
University of Washington, Department of Biostatistics, Seattle, WA, USA.
Robyn L
RL
McClelland
University of California, San Diego, Dept. of Family Medicine and Public Health, La Jolla, CA, USA.
Rosemay A
RA
Remigio-Baker
University of California, San Diego, Dept. of Family Medicine and Public Health, La Jolla, CA, USA; Veterans Administration San Diego Healthcare System, La Jolla, CA, USA.
Matthew A
MA
Allison
National Institutes of Health, Clinical Center, Bethesda, MD, USA.
Veit
V
Sandfort
Johns Hopkins University, Department of Medicine, Baltimore, MD, USA.
Erin D
ED
Michos
University of California, San Diego, Dept. of Family Medicine and Public Health, La Jolla, CA, USA.
Isac
I
Thomas
University of California, San Diego, Dept. of Family Medicine and Public Health, La Jolla, CA, USA; Veterans Administration San Diego Healthcare System, La Jolla, CA, USA.
Dena E
DE
Rifkin
University of California, San Diego, Dept. of Family Medicine and Public Health, La Jolla, CA, USA.
Michael H
MH
Criqui
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000737:chemistry* / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000208:ethnology / Q000378:metabolism*; D001213:Asian; D002118:Calcium / Q000032:analysis*; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000208:ethnology / Q000378:metabolism*; D044465:White People
D002118:Calcium
Abdominal aortic calcium; Agatston calcium score; Cardiovascular disease risk factors; Coronary artery calcium; Density calcium score; Volume calcium score