Risk factors associated with coronary artery calcification in midlife women: a population-based study

Abstract

The aim of this study was to investigate the association between individual risk factors and coronary artery calcification (CAC), as a marker of subclinical cardiovascular disease, in a population-based nested cross-sectional study of midlife women. Anthropometric and metabolic data from 295 women from the South of Brazil were analyzed. Habitual physical activity was assessed by pedometer. CAC was assessed by a multi-detector computed tomography system. Average Agatston score was used to stratify participants as CAC > 0 and CAC = 0. Women with CAC > 0 (34.7%) were older (58.7 ± 5.4 vs. 56.3 ± 5.2 years, p < .001) and had higher prevalence of central adiposity (71 vs. 59%, p = .04) and hypertension (71 vs. 52%, p = .002) than women in the CAC = 0 group. Hormone therapy (HT) was more prevalent in the group with CAC = 0 (19.7 vs. 9.8%, p = .029). The prevalence ratios for CAC > 0 were 0.545 (95%CI:0.309–0.962, p = .036) for HT and 1.752 (95%CI:1.207–2.541, p = .003) for hypertension, after adjustment for age, educational level, smoking, alcohol intake, and physical activity. The present data in a population-based sample of midlife women indicate that hypertension and age were positively associated with higher risk for CAC > 0 and HT was related with CAC = 0.

摘要

本研究的目的是在一项以人群为基础的中年女性嵌套横断面研究中, 研究个体危险因素与冠状动脉钙化（CAC）之间的关系, 后者是亚临床心血管疾病的标志。对来自巴西南部295名妇女的人体测量和代谢数据进行了分析, 其中用计步器测定受试者的习惯性体力活动；应用多探测器计算机断层扫描系统评估其CAC；应用平均阿加斯顿评分用于将受试者分层为CAC>0和CAC=0两组。CAC>0（34.7%）的女性年龄较大（58.7±5.4 vs.56.3±5.2岁, P<0.001）, 中心性肥胖（71vs.59%, P<0.04）和高血压（71 vs.52%, P<0.002）的患病率高于CAC=0组的女性。激素治疗（HT）在CAC=0组中更为普遍（19.7 vs.9.8%, P=.029）。校正年龄、受教育水平、吸烟、饮酒和体育活动后, 对于激素治疗, CAC>0的患病率为0.545（95%CI:0.309-0.962, P<0.036）, 对于高血压, CAC>0的患病率为1.752（95%CI:1.207-2.541, P<0.003）。以人群为基础的中年妇女样本中的现有数据表明, 高血压和年龄与CAC>0的高风险呈正相关, 而HT与CAC=0呈相关。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Menopause
• coronary artery calcification
• cardiovascular risk
• midlife women
• hormone therapy

Acknowledgements

The authors thank Gabriela Ambrós, MD, for her support with CT for CAC assessment.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was supported by grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq INCT 465482/2014-7), Brazil.