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European Heart Journal 2004 25(1):48-55; doi:10.1016/j.ehj.2003.10.008
Copyright © 2004 by the European Society of Cardiology.
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Clinical research

Risk factors for coronary calcification in older subjects

The Rotterdam Coronary Calcification Study

Hok-Hay S. Oeia,b, Rozemarijn Vliegentharta,b, Albert Hofmana, Matthijs Oudkerkb,c and Jacqueline C.M. Wittemana,*

a Department of Epidemiology & Biostatistics, Erasmus MC, Rotterdam, The Netherlands
b Department of Radiology, State University Groningen/Academic Hospital Groningen, Groningen, The Netherlands
c Department of Radiology, Daniel den Hoed Clinic, Erasmus MC, Rotterdam, The Netherlands

* Correspondence to: Dr J. C. M. Witteman, Department of Epidemiology & Biostatistics, Erasmus MC, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Tel: +31 10 4087365; Fax: +31 10 4089382
E-mail address: j.witteman{at}erasmusmc.nl

Received 27 May 2003; revised 3 October 2003; accepted 16 October 2003

Abstract

Aims We examined associations between cardiovascular risk factors and coronary calcification assessed by electron-beam tomography (EBT) in an unselected population of older subjects.

Methods and results The Rotterdam Coronary Calcification Study is a population-based study in subjects >=55 years. Participants underwent EBT scanning. Coronary calcification was quantified according to the Agatston score. Cardiovascular risk factors were assessed 7 years before and concurrently to scanning. We used the first 2013 participants for the present analyses. Risk factors assessed 7 years before scanning were strongly associated with calcium score. Associations with blood pressure and cholesterol attenuated when measured concurrently to scanning. Although the number of risk factors was strongly associated with a high calcium score in asymptomatic subjects, 29% of the men and 15% of the women without risk factors had a high calcium score.

Conclusions This population-based study in older subjects shows that cardiovascular risk factors are associated with coronary calcification. Associations were stronger for risk factors measured at earlier age. Almost 30% of the men and 15% of the women without risk factors had extensive coronary calcification.

Key Words: Atherosclerosis • Calcium • Tomography • Coronary disease • Risk factors


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