Nav: Home

Calcium specks may help detect heart disease in South Asians

January 11, 2019

Specks of calcium in the heart's artery walls could be an important prognostic marker of early cardiovascular disease in South Asians and may help guide treatment in this population, according to a study by researchers at UC San Francisco.

In a study of nearly 700 patients with ethnic backgrounds from India, Pakistan, Bangladesh, Sri Lanka, Nepal and Bhutan, UCSF researchers found that South Asian men had the same high rates of change in calcification of their artery walls over a five-year period as white men, the group with the highest rates of cardiovascular disease.

South Asians are known to have a high chance of developing cardiovascular disease and represent more than 60 percent of cardiovascular disease patients worldwide. They also develop risk factors such as high blood pressure, cholesterol and diabetes at a younger age than other racial and ethnic groups. However, it remains unclear which clinical factors could help determine those at highest risk.

"While South Asians have high cardiovascular disease rates, there are few prospective studies in the world that have focused on determining the risk factors," said lead author Alka Kanaya, MD, UCSF Health internist and professor of medicine at UCSF. "The presence and change of coronary artery calcium may be useful for risk prediction in this ethnic population and may better guide the judicious use of statin and other preventive therapies."

Early signs of coronary artery calcification (CAC), in which calcium specks appear in artery walls, can be detected through a computed tomography (CT) scan. In other ethnic groups, high CAC scores have been proven to be an early sign of those at high risk of developing cardiovascular disease.

The American Heart Association recently recommended CAC testing in individuals with intermediate heart disease risk to help determine whether they should be treated with cholesterol-lowering medications. These guidelines classify South Asians as a high-risk group.

The study, appearing online Jan. 11, 2019, in the Journal of the American Heart Association (JAHA), is among the findings being generated by the ongoing Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Led by Kanaya, MASALA is the first long-term study in this population that aims to better understand the factors leading to heart disease and guide prevention and treatment. Since the study began in 2010, it has enrolled more than 1,100 South Asian immigrants living in the San Francisco Bay Area and greater Chicago area, most of whom have spent decades in the United States.

In the JAHA study, Kanaya and her colleagues measured calcification in 698 MASALA patients from CT scans taken five years apart. They compared the incidence and progression rates of CAC to other populations using data from the Multi-Ethnic Study of Atherosclerosis (MESA), a study similar to MASALA that is investigating potential factors for early atherosclerosis in more than 6,800 diverse participants from six U.S. cities.

The researchers found that South Asian men had a higher rate of new calcification than South Asian women, 8.8 percent to 3.6 percent, respectively. After accounting for differences in age, diabetes, high blood pressure and statin use, increases in CAC were similar in South Asian men compared to white men but 122 percent, 64 percent and 54 percent larger than the increases in African Americans, Latinos and Chinese Americans, respectively. There was no significant difference in the amount of CAC change among women in different race/ethnic groups.

"Both CAC burden and progression have been shown to be independent predictors of coronary heart disease in whites, blacks, Latinos and Chinese Americans," Kanaya said. "The next step for us is to determine if CAC burden and/or progression predicts those at highest risk of having a heart attack or stroke among South Asians."
-end-
Co-Authors: Senior author Matthew Budoff, UCLA Medical Center; Eric Vittinghoff and Feng Lin, UCSF; Namratha Kandula and Kiang Liu, Northwestern University; David Herrington, Wake Forest University Medical Center; and Michael Blaha, Johns Hopkins University.

Funding: The MASALA study is supported by National Institutes of Health grants 1R01HL093009, 2R01HL093009, R01HL120725 and K24HL112827, and at UCSF with grants UL1RR024131, UL1TR001872 and P30DK09 8722. The MESA study was funded by contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute and by grants UL1-TR-000040 and UL1-TR-001079 from the NCRR.

Disclosures: The authors report no conflicts of interest.

About UCSF: UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises three top-ranked hospitals - UCSF Medical Center and UCSF Benioff Children's Hospitals in San Francisco and Oakland - as well as Langley Porter Psychiatric Hospital and Clinics, UCSF Benioff Children's Physicians and the UCSF Faculty Practice. UCSF Health has affiliations with hospitals and health organizations throughout the Bay Area. UCSF faculty also provide all physician care at the public Zuckerberg San Francisco General Hospital and Trauma Center, and the SF VA Medical Center. The UCSF Fresno Medical Education Program is a major branch of the University of California, San Francisco's School of Medicine. Please visit http://www.ucsf.edu/news.

MEDIA AVAILABLE: Infographic on South Asian heart disease risk is available here.

University of California - San Francisco

Related Heart Disease Articles:

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.
Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.
New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.
Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.
Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.
Women once considered low risk for heart disease show evidence of previous heart attack scars
Women who complain about chest pain often are reassured by their doctors that there is no reason to worry because their angiograms show that the women don't have blockages in the major heart arteries, a primary cause of heart attacks in men.
Where you live could determine risk of heart attack, stroke or dying of heart disease
People living in parts of Ontario with better access to preventive health care had lower rates of cardiac events compared to residents of regions with less access, found a new study published in CMAJ (Canadian Medical Association Journal).
Older adults with heart disease can become more independent and heart healthy with physical activity
Improving physical function among older adults with heart disease helps heart health and even the oldest have a better quality of life and greater independence.
Dietary factors associated with substantial proportion of deaths from heart disease, stroke, and disease
Nearly half of all deaths due to heart disease, stroke, and type 2 diabetes in the US in 2012 were associated with suboptimal consumption of certain dietary factors, according to a study appearing in the March 7 issue of JAMA.
Certain heart fat associated with higher risk of heart disease in postmenopausal women
For the first time, researchers have pinpointed a type of heart fat, linked it to a risk factor for heart disease and shown that menopausal status and estrogen levels are critical modifying factors of its associated risk in women.
More Heart Disease News and Heart Disease Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

In & Out Of Love
We think of love as a mysterious, unknowable force. Something that happens to us. But what if we could control it? This hour, TED speakers on whether we can decide to fall in — and out of — love. Guests include writer Mandy Len Catron, biological anthropologist Helen Fisher, musician Dessa, One Love CEO Katie Hood, and psychologist Guy Winch.
Now Playing: Science for the People

#542 Climate Doomsday
Have you heard? Climate change. We did it. And it's bad. It's going to be worse. We are already suffering the effects of it in many ways. How should we TALK about the dangers we are facing, though? Should we get people good and scared? Or give them hope? Or both? Host Bethany Brookshire talks with David Wallace-Wells and Sheril Kirschenbaum to find out. This episode is hosted by Bethany Brookshire, science writer from Science News. Related links: Why Climate Disasters Might Not Boost Public Engagement on Climate Change on The New York Times by Andrew Revkin The other kind...
Now Playing: Radiolab

An Announcement from Radiolab