The effects of multiple coronary artery disease risk factors on subclinical atherosclerosis in a rural population in the United States

Hadii M. Mamudu, Timir K. Paul, Liang Wang, Sreenivas P. Veeranki, Hemang B. Panchal, Arsham Alamian, Kamrie Sarnosky, Matthew Budoff

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Introduction: The risk factors for cardiovascular disease (CVD) are associated with coronary atherosclerosis and having multiple risk factors potentiates atherosclerosis. This study examined the prevalence of multiple biological and lifestyle/behavioral risk factors and their association with coronary artery calcium (CAC), a marker for subclinical coronary atherosclerosis. Methods: This is a cross-sectional study of 1607 community-dwelling asymptomatic individuals from central Appalachia who participated in CAC screening between January 2011 and December 2012. Data on demographics (sex and age) and 7 traditional risk factors for coronary artery disease (CAD) were collected and categorized into 5 groups (0-1, 2, 3, 4, and ≥. 5). Prevalence of these risk factors and CAC scores (0, 1-99, 100-399, ≥. 400) were assessed, and the impact of the number of risk factors on CAC scores were delineated using multiple logistic regression. Results: Over 98% of participants had ≥. 1 risk factor. While obesity, diabetes, hypertension, and family history of CAD significantly increased the odds of having CAC, CAC scores significantly increased with number of risk factors. After adjusting for demographic factors, having 3, 4, and ≥. 5 risk factors was significantly associated with increased odds of having higher CAC scores when compared to zero CAC score by more than one and half times [OR = 1.65, CI (1.20-2.25)], two times [OR = 2.32, CI (1.67-3.23)] and three times [OR = 3.45, CI (2.42-4.92)], respectively. Conclusion: The high prevalence of multiple risk factors in the study population suggests the need for aggressive multiple risk factors interventions for primary prevention of CAD, which could address CVD health disparities.

Original languageEnglish (US)
Pages (from-to)140-146
Number of pages7
JournalPreventive Medicine
Volume88
DOIs
StatePublished - Jul 1 2016

Fingerprint

Rural Population
Coronary Artery Disease
Atherosclerosis
Coronary Vessels
Calcium
Cardiovascular Diseases
Appalachian Region
Cross-Sectional Studies
Demography
Independent Living
Primary Prevention
Life Style
Obesity
Logistic Models
Hypertension

Keywords

  • Appalachia
  • Clustering of risk factors
  • Coronary artery calcium
  • Coronary artery disease
  • Multiple risk factors
  • Subclinical atherosclerosis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

The effects of multiple coronary artery disease risk factors on subclinical atherosclerosis in a rural population in the United States. / Mamudu, Hadii M.; Paul, Timir K.; Wang, Liang; Veeranki, Sreenivas P.; Panchal, Hemang B.; Alamian, Arsham; Sarnosky, Kamrie; Budoff, Matthew.

In: Preventive Medicine, Vol. 88, 01.07.2016, p. 140-146.

Research output: Contribution to journalArticle

Mamudu, Hadii M. ; Paul, Timir K. ; Wang, Liang ; Veeranki, Sreenivas P. ; Panchal, Hemang B. ; Alamian, Arsham ; Sarnosky, Kamrie ; Budoff, Matthew. / The effects of multiple coronary artery disease risk factors on subclinical atherosclerosis in a rural population in the United States. In: Preventive Medicine. 2016 ; Vol. 88. pp. 140-146.
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abstract = "Introduction: The risk factors for cardiovascular disease (CVD) are associated with coronary atherosclerosis and having multiple risk factors potentiates atherosclerosis. This study examined the prevalence of multiple biological and lifestyle/behavioral risk factors and their association with coronary artery calcium (CAC), a marker for subclinical coronary atherosclerosis. Methods: This is a cross-sectional study of 1607 community-dwelling asymptomatic individuals from central Appalachia who participated in CAC screening between January 2011 and December 2012. Data on demographics (sex and age) and 7 traditional risk factors for coronary artery disease (CAD) were collected and categorized into 5 groups (0-1, 2, 3, 4, and ≥. 5). Prevalence of these risk factors and CAC scores (0, 1-99, 100-399, ≥. 400) were assessed, and the impact of the number of risk factors on CAC scores were delineated using multiple logistic regression. Results: Over 98{\%} of participants had ≥. 1 risk factor. While obesity, diabetes, hypertension, and family history of CAD significantly increased the odds of having CAC, CAC scores significantly increased with number of risk factors. After adjusting for demographic factors, having 3, 4, and ≥. 5 risk factors was significantly associated with increased odds of having higher CAC scores when compared to zero CAC score by more than one and half times [OR = 1.65, CI (1.20-2.25)], two times [OR = 2.32, CI (1.67-3.23)] and three times [OR = 3.45, CI (2.42-4.92)], respectively. Conclusion: The high prevalence of multiple risk factors in the study population suggests the need for aggressive multiple risk factors interventions for primary prevention of CAD, which could address CVD health disparities.",
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AU - Mamudu, Hadii M.

AU - Paul, Timir K.

AU - Wang, Liang

AU - Veeranki, Sreenivas P.

AU - Panchal, Hemang B.

AU - Alamian, Arsham

AU - Sarnosky, Kamrie

AU - Budoff, Matthew

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N2 - Introduction: The risk factors for cardiovascular disease (CVD) are associated with coronary atherosclerosis and having multiple risk factors potentiates atherosclerosis. This study examined the prevalence of multiple biological and lifestyle/behavioral risk factors and their association with coronary artery calcium (CAC), a marker for subclinical coronary atherosclerosis. Methods: This is a cross-sectional study of 1607 community-dwelling asymptomatic individuals from central Appalachia who participated in CAC screening between January 2011 and December 2012. Data on demographics (sex and age) and 7 traditional risk factors for coronary artery disease (CAD) were collected and categorized into 5 groups (0-1, 2, 3, 4, and ≥. 5). Prevalence of these risk factors and CAC scores (0, 1-99, 100-399, ≥. 400) were assessed, and the impact of the number of risk factors on CAC scores were delineated using multiple logistic regression. Results: Over 98% of participants had ≥. 1 risk factor. While obesity, diabetes, hypertension, and family history of CAD significantly increased the odds of having CAC, CAC scores significantly increased with number of risk factors. After adjusting for demographic factors, having 3, 4, and ≥. 5 risk factors was significantly associated with increased odds of having higher CAC scores when compared to zero CAC score by more than one and half times [OR = 1.65, CI (1.20-2.25)], two times [OR = 2.32, CI (1.67-3.23)] and three times [OR = 3.45, CI (2.42-4.92)], respectively. Conclusion: The high prevalence of multiple risk factors in the study population suggests the need for aggressive multiple risk factors interventions for primary prevention of CAD, which could address CVD health disparities.

AB - Introduction: The risk factors for cardiovascular disease (CVD) are associated with coronary atherosclerosis and having multiple risk factors potentiates atherosclerosis. This study examined the prevalence of multiple biological and lifestyle/behavioral risk factors and their association with coronary artery calcium (CAC), a marker for subclinical coronary atherosclerosis. Methods: This is a cross-sectional study of 1607 community-dwelling asymptomatic individuals from central Appalachia who participated in CAC screening between January 2011 and December 2012. Data on demographics (sex and age) and 7 traditional risk factors for coronary artery disease (CAD) were collected and categorized into 5 groups (0-1, 2, 3, 4, and ≥. 5). Prevalence of these risk factors and CAC scores (0, 1-99, 100-399, ≥. 400) were assessed, and the impact of the number of risk factors on CAC scores were delineated using multiple logistic regression. Results: Over 98% of participants had ≥. 1 risk factor. While obesity, diabetes, hypertension, and family history of CAD significantly increased the odds of having CAC, CAC scores significantly increased with number of risk factors. After adjusting for demographic factors, having 3, 4, and ≥. 5 risk factors was significantly associated with increased odds of having higher CAC scores when compared to zero CAC score by more than one and half times [OR = 1.65, CI (1.20-2.25)], two times [OR = 2.32, CI (1.67-3.23)] and three times [OR = 3.45, CI (2.42-4.92)], respectively. Conclusion: The high prevalence of multiple risk factors in the study population suggests the need for aggressive multiple risk factors interventions for primary prevention of CAD, which could address CVD health disparities.

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KW - Clustering of risk factors

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