Nav: Home

Higher coronary artery calcium levels in middle-age may indicate higher risk for future heart problems

June 14, 2019

DALLAS, June 14, 2019 -- Higher coronary artery calcium levels in middle-age were associated with structural heart abnormalities linked to future heart failure, particularly among blacks, according to new research in Circulation: Cardiovascular Imaging, an American Heart Association journal.

Coronary artery calcium (CAC) is the buildup of calcified plaque made up of fat, calcium and cholesterol. The calcium found in this type of plaque is not related to dietary calcium. Elevated cholesterol levels in the blood can contribute to plaque buildup, known as atherosclerosis, which narrows the channel within an artery and reduces blood flow.

CAC is a risk marker for heart health problems, and CAC screening was added to the American Heart Association's 2018 cholesterol management guidelines to further improve early detection of heart health abnormalities, especially among people who might be at a higher risk. A CAC score of zero indicates there is low risk in the absence of other high-risk conditions, while a score above zero indicates increasing risk.

In this study, researchers tracked 2,449 people (52% white, 57% women) from young adulthood to middle-age. Non-invasive computed tomography imaging tests were used to gauge the participants' vascular health, with participants' imaging tests and CAC scores compared at years 15 and 25 of the study period.

By year 25, participants' average age was about 50. Seventy-two percent of the group had a CAC score of zero compared with 77% a decade earlier.

"We looked at early adulthood to middle-age because this is a window in which we can see abnormalities that might not be causing symptoms, but could later increase the risk of heart problems," said Henrique Turin Moreira, M.D., Ph.D., study co-author and an attending physician at Hospital das Clínicas de Ribeirão Preto at the University of São Paulo in Brazil. "Prevention and control of these abnormalities are key, so early identification of risks can be crucial."

Moreira and team found that increases in CAC scores were independently related to increasing age, male sex, black race, higher systolic blood pressure, higher total cholesterol, diabetes mellitus and current smoking, as well as the use of medications to lower blood pressure and cholesterol. Additionally, they found:
  • Compared with patients who had CAC scores of zero, those who had higher CAC scores at middle-age had a 12% increase in left ventricular mass and a 9% increase in left ventricular volume, independent of other risk factors including demographic information and cardiovascular risks. Abnormalities in the left ventricle means the heart had to work harder to effectively pump blood, and as a result, became enlarged and thickened, a risk factor for heart failure.

  • These findings were even more significant among blacks. For every one-unit change in a CAC score, blacks had four times higher increase in left ventricular mass compared with whites.

  • While progression in CAC over the follow-up was strongly related to higher left ventricular mass in blacks, this relationship was not significant in whites.

Blacks already face a greater risk and burden of heart disease and stroke: 60% of adult black men and 57% of adult black women have some form of cardiovascular disease, compared with 50% of white men and 43% of white women.

"Racial differences in our findings may be due to genetic factors or perhaps greater exposure to cardiovascular risk factors that usually appear earlier in blacks," Moreira said. "We need more research to examine the link between coronary artery calcium and heart health."

"Prior studies have shown that presence of CAC and higher CAC scores are associated with atherosclerotic cardiovascular disease in young to middle aged adults. The results of this study are important as they highlight that presence of CAC and higher CAC scores may also be associated with echocardiographic markers of subclinical LV systolic and diastolic dysfunction," said Salim Virani, M.D., a member of the writing committee for the American Heart Association's 2018 cholesterol guidelines and director of the Cardiology Fellowship Training Program at Baylor College of Medicine in Houston. "Given the burden of morbidity and mortality associated with heart failure, these are important findings. Prior studies from this cohort have also shown that a better risk factors profile in young adulthood is associated with much lower CAC and therefore, these results further highlight the importance of primordial prevention and risk factor modification in early adulthood."
-end-
Co-authors are: Guilherme S. Yared, M.D.; Bharath A. Venkatesh, Ph.D.; Henrique D. Vasconcellos, M.D., M.Sc.; Chike C. Nwabuo, M.D., M.P.H.; Mohammad R. Ostovaneh, M.D.; Jared P. Reis, Ph.D.; Donald M. Lloyd-Jones, M.D., M.Sc.; Pamela J. Schreiner, Ph.D.; Cora E. Lewis, M.D., M.S.P.H.; Stephen Sidney, M.D., M.P.H.; John Jeffrey Carr, M.D., M.Sc.; Samuel S. Gidding, M.D.; and João A.C. Lima, M.D. Author disclosures are on the manuscript.

Data from The CARDIA study was used for this research. The CARDIA study is supported by the National Heart, Lung, and Blood Institute (NHLBI), the Intramural Research Program of the National Institute on Aging (NIA), and an intra-agency agreement between NIA and NHLBI.

Additional Resources:

Available multimedia is on right column of release link - https://newsroom.heart.org/news/higher-coronary-artery-calcium-levels-in-middle-age-may-indicate-higher-risk-for-future-heart-problems?preview=8451abc3a782780bac49beb62f283057

After June 14, view the manuscript online.

Follow AHA/ASA news on Twitter @HeartNews

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Heart Failure Articles:

New hope for treating heart failure
Heart failure patients who are getting by on existing drug therapies can look forward to a far more effective medicine in the next five years or so, thanks to University of Alberta researchers.
Activated T-cells drive post-heart attack heart failure
Chronic inflammation after a heart attack can promote heart failure and death.
ICU care for COPD, heart failure and heart attack may not be better
Does a stay in the intensive care unit give patients a better chance of surviving a chronic obstructive pulmonary disease (COPD) or heart failure flare-up or even a heart attack, compared with care in another type of hospital unit?
Tissue engineering advance reduces heart failure in model of heart attack
Researchers have grown heart tissue by seeding a mix of human cells onto a 1-micron-resolution scaffold made with a 3-D printer.
Smoking may lead to heart failure by thickening the heart wall
Smokers without obvious signs of heart disease were more likely than nonsmokers and former smokers to have thickened heart walls and reduced heart pumping ability.
More Heart Failure News and Heart Failure Current Events

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

Teaching For Better Humans
More than test scores or good grades — what do kids need to prepare them for the future? This hour, guest host Manoush Zomorodi and TED speakers explore how to help children grow into better humans, in and out of the classroom. Guests include educators Olympia Della Flora and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#535 Superior
Apologies for the delay getting this week's episode out! A technical glitch slowed us down, but all is once again well. This week, we look at the often troubling intertwining of science and race: its long history, its ability to persist even during periods of disrepute, and the current forms it takes as it resurfaces, leveraging the internet and nationalism to buoy itself. We speak with Angela Saini, independent journalist and author of the new book "Superior: The Return of Race Science", about where race science went and how it's coming back.