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:

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.
Maternal chronic disease linked to higher rates of congenital heart disease in babies
Pregnant women with congenital heart defects or type 2 diabetes have a higher risk of giving birth to babies with severe congenital heart disease and should be monitored closely in the prenatal period, according to a study published in CMAJ.
Novel heart valve replacement offers hope for thousands with rheumatic heart disease
A novel heart valve replacement method is revealed today that offers hope for the thousands of patients with rheumatic heart disease who need the procedure each year.
Younger heart attack survivors may face premature heart disease death
For patients age 50 and younger, the risk of premature death after a heart attack has dropped significantly, but their risk is still almost twice as high when compared to the general population, largely due to heart disease and other smoking-related diseases The risk of heart attack can be greatly reduced by quitting smoking, exercising and following a healthy diet.
Citrus fruits could help prevent obesity-related heart disease, liver disease, diabetes
Oranges and other citrus fruits are good for you -- they contain plenty of vitamins and substances, such as antioxidants, that can help keep you healthy.
Gallstone disease may increase heart disease risk
A history of gallstone disease was linked to a 23 percent increased risk of developing coronary heart disease.
Americans are getting heart-healthier: Coronary heart disease decreasing in the US
Coronary heart disease is one of the leading causes of death in the United States.

Related Heart Disease Reading:

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 2-Volume Set
by Douglas P. Zipes MD (Author), Peter Libby MD PhD (Author), Robert O. Bonow MD MS (Author), Douglas L. Mann MD (Author), Gordon F. Tomaselli MD (Author)

Pathophysiology of Heart Disease: A Collaborative Project of Medical Students and Faculty
by Leonard S. Lilly MD (Author)

Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure
by Caldwell B. Esselstyn Jr. (Author)

The Prevent and Reverse Heart Disease Cookbook: Over 125 Delicious, Life-Changing, Plant-Based Recipes
by Ann Crile Esselstyn (Author), Jane Esselstyn (Author)

The End of Heart Disease: The Eat to Live Plan to Prevent and Reverse Heart Disease
by Joel Fuhrman M.D. (Author)

Illustrated Field Guide to Congenital Heart Disease and Repair - Pocket Sized
by Allen D. Everett (Author), D. Scott, M.D. Lim (Author), Paul Burns (Illustrator), Jasper Burns (Illustrator), Marcia L. Buck (Illustrator), Jane E., M.D. Crosson (Illustrator)

The Simple Heart Cure: The 90-Day Program to Stop and Reverse Heart Disease
by Chauncey Crandall (Author)

Moss & Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult (2 Volume Set)
by Hugh D. Allen MD FACC FAAP FAHA (Author)

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 2-Volume Set
by Douglas L. Mann MD (Author), Douglas P. Zipes MD (Author), Peter Libby MD PhD (Author), Robert O. Bonow MD MS (Author)

Heart Solution for Women: A Proven Program to Prevent and Reverse Heart Disease
by Mark Menolascino M.D. (Author)

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Approaching With Kindness
We often forget to say the words "thank you." But can those two words change how you — and those around you — look at the world? This hour, TED speakers on the power of gratitude and appreciation. Guests include author AJ Jacobs, author and former baseball player Mike Robbins, Dr. Laura Trice, Professor of Management Christine Porath, and former Danish politician Özlem Cekic.
Now Playing: Science for the People

#509 Anisogamy: The Beginning of Male and Female
This week we discuss how the sperm and egg came to be, and how a difference of reproductive interest has led to sexual conflict in bed bugs. We'll be speaking with Dr. Geoff Parker, an evolutionary biologist credited with developing a theory to explain the evolution of two sexes, about anisogamy, sexual reproduction through the fusion of two different gametes: the egg and the sperm. Then we'll speak with Dr. Roberto Pereira, research scientist in urban entomology at the University of Florida, about traumatic insemination in bed bugs.