July 16, 2013
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Longer duration of obesity tied to higher risk for coronary artery calcification

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The longer a patient has had overall and abdominal obesity, the more likely he is to develop coronary artery calcification, a subclinical predictor of CHD, according to results of a 3-decade study.

The CARDIA study tracked white and black adults aged 18 to 30 years (n=3,275; 50.6% women) at the beginning of the study period in 1985 to 1986. At baseline, participants did not have overall obesity (BMI ≥30) or abdominal obesity (men: waist circumference >40.2 inches; women: >34.6 inches). Participants were evaluated at centers in Birmingham, Ala., Minneapolis, Chicago and Oakland, Calif.

All participants underwent CT scanning of the chest for coronary artery calcification at 15-year (2000-2001), 20-year (2005-2006) and 25-year (2010-2011) follow-up exams. Each time a calcified lesion was detected, a calcium score in Agaston units was calculated. The lesion score was added together to produce a total calcium score. Researchers defined the presence of coronary artery calcification as total calcium score >0 Agaston units. For those who underwent scans at 15 and 25 years, the team also studied the association of duration of overall and abdominal obesity with the 10-year progression of coronary artery calcification.

By the end of the study period, 40.4% of participants had developed overall obesity and 41% developed abdominal obesity. Presence of coronary artery calcification was detected in 27.5% (n=902).

The presence and extent of coronary artery calcification were strongly associated with the duration of overall and abdominal obesity (P<.001 for both). Among those with more than 20 years of overall and abdominal obesity, 25.2% and 27.7%, respectively, showed progression of coronary artery calcification. By comparison, among those with 0 years of overall and abdominal obesity, 20.2% and 19.5%, respectively, showed progression of coronary artery calcification. The HRs for coronary artery calcification for each additional year of overall obesity was 1.02 (95% CI, 1.01-1.03) and each additional year of abdominal obesity was 1.03 (95% CI, 1.02-1.05); adjusted ORs for coronary artery calcification progression were 1.04 (95% CI, 1.01-1.06) and 1.04 (95% CI, 1.01-1.07).

Disclosure: The researchers report no relevant financial disclosures.