@article {682, title = {Racial differences in coronary artery calcification in older adults.}, journal = {Arterioscler Thromb Vasc Biol}, volume = {22}, year = {2002}, month = {2002 Mar 01}, pages = {424-30}, abstract = {

Reports on race-related differences in coronary artery calcium (CAC) are just beginning to emerge and have not been well studied in the elderly. This study was undertaken to assess whether such differences exist and the relationship between CAC and cardiovascular risk factors in a cohort of elderly community-dwelling adults. CAC was measured by using electron-beam tomography in 614 adults (aged 67 to 99 years), of whom 59\% were women and 23\% were black. The median CAC score was lower in blacks than in whites for men (159 versus 787, respectively; P<0.001) and for women (134 versus 233, respectively; P=0.02) after adjustment for age, cardiovascular disease, and risk factors for cardiovascular disease, although this difference was stronger and remained significant among men only. Lower CAC scores were also observed in the subgroup of blacks with a history of myocardial infarction. The lower CAC scores in blacks compared with whites observed in this study is consistent with either a lower prevalence of coronary artery disease or a lower extent of calcification of coronary artery disease.

}, keywords = {Age Factors, Aged, Calcinosis, Cohort Studies, Coronary Artery Disease, Female, Humans, Logistic Models, Male, Risk Factors, Sex Factors, Tomography, X-Ray Computed}, issn = {1524-4636}, doi = {10.1161/hq0302.105357}, author = {Newman, Anne B and Naydeck, Barbara L and Whittle, Jeff and Sutton-Tyrrell, Kim and Edmundowicz, Daniel and Kuller, Lewis H} } @article {704, title = {Relationship between coronary artery calcification and other measures of subclinical cardiovascular disease in older adults.}, journal = {Arterioscler Thromb Vasc Biol}, volume = {22}, year = {2002}, month = {2002 Oct 01}, pages = {1674-9}, abstract = {

BACKGROUND: In the Cardiovascular Health Study, subclinical cardiovascular disease (CVD) predicted CVD events in older adults. The extent to which this measure or its components reflect calcified coronary disease is unknown.

METHODS AND RESULTS: Coronary artery calcium (CAC) was assessed with electron beam tomography in 414 participants without clinical CVD and examined using cut points (CAC> or =400 and CAC> or =800) and the log(CAC); 274 had subclinical CVD by ankle-arm index, ECG, or carotid ultrasound. Cut points for subclinical disease as previously defined in the Cardiovascular Health Study were examined as well as continuous measures to produce receiver operating characteristic curve curves. A low ankle-arm index was highly specific for a high CAC score. The internal carotid artery intima-media thickness was most strongly correlated with CAC (r=0.30) and was significantly related to both CAC cut points and to the log(CAC) score independently of all other measures.

CONCLUSIONS: In these community-dwelling older adults without clinical CVD, internal carotid artery intima-media thickness was most closely related to CAC. However, 17.5\% of those with a CAC> or =400 would be missed in the ascertainment of subclinical atherosclerosis using the previously published composite of subclinical atherosclerosis. Prospective follow-up will determine whether the CAC score improves prediction of CVD events over other noninvasive measures.

}, keywords = {Aged, Aged, 80 and over, Calcinosis, Cardiovascular Diseases, Carotid Stenosis, Cohort Studies, Coronary Artery Disease, Demography, Female, Humans, Male, Prevalence, Risk Factors, Sensitivity and Specificity, Sex Factors, Tomography, X-Ray Computed, Tunica Intima, Tunica Media}, issn = {1524-4636}, doi = {10.1161/01.atv.0000033540.89672.24}, author = {Newman, Anne B and Naydeck, Barbara L and Sutton-Tyrrell, Kim and Edmundowicz, Daniel and O{\textquoteright}Leary, Daniel and Kronmal, Richard and Burke, Gregory L and Kuller, Lewis H} } @article {1060, title = {Coronary artery calcium and physical function in older adults: the Cardiovascular Health Study.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {63}, year = {2008}, month = {2008 Oct}, pages = {1112-8}, abstract = {

BACKGROUND: In older adults without clinical cardiovascular disease, coronary artery calcium (CAC) is associated with other subclinical vascular diseases, which, in turn, predict physical dysfunction. However, the association between CAC and physical function is unstudied.

METHODS: In 387 older community-dwellers from the Cardiovascular Health Study without clinical cardiovascular diseases (mean age +/- standard deviation = 78.7 +/- 3.7, 35\% men, 22\% African Americans), CAC was measured using electron beam tomography, and physical performance was assessed by usual pace gait speed, chair stand, and tandem stand. Differences in physical performance across CAC quartiles were investigated in the whole cohort and by gender. Associations with gait speed (m/s) were assessed in multivariable models using both the continuous form of CAC score (log(CAC)) and quartiles of CAC, adjusting for demographics and comorbidities.

RESULTS: No differences in physical performance were observed across CAC quartiles in the whole group. In gender-stratified analyses, a significant association was shown among women, who had progressively lower gait speed across CAC quartiles: Those with CAC > 220 walked more than 0.1 m/s slower than those with CAC < 35 (age-adjusted ptrend =.017). After multivariable adjustment, the association remained statistically significant for women in both linear (log(CAC) and gait speed, p =.025) and logistic models: Each of the top three CAC quartiles (35-220, 221-659, and > or = 660) had a more than twofold odds of walking slower than 1 m/s, compared to the lowest CAC quartile (< 35; p =.021).

CONCLUSIONS: In this sample of older community-dwellers without overt cardiovascular disease, CAC was inversely related to gait speed in women, but not in men.

}, keywords = {Aged, Aged, 80 and over, Analysis of Variance, Calcinosis, Coronary Artery Disease, Female, Geriatric Assessment, Humans, Male, Regression Analysis, Risk Factors, Tomography, X-Ray Computed, Walking}, issn = {1079-5006}, doi = {10.1093/gerona/63.10.1112}, author = {Inzitari, Marco and Naydeck, Barbara L and Newman, Anne B} }