Impact of clusters of risk factors on subclinical coronary artery disease among asymptomatic rural population
Methods: The study included 1607 asymptomatic individuals from Central Appalachia who participated in screening for CAC scores between January 2011 and December 2012. Self-reported data on demographics and 7 risk factors (obesity, diabetes, hypercholesterolemia, hypertension, smoking, sedentary lifestyle, and family history of CAD) were categorized into three clusters of risk factors (<3, 3-5, and >5) for the analysis. We examined the mean CAC scores by cluster and delineated the impact of clusters of risk factors on CAC score using multiple logistic regression.
Results: Of the participants in the CAC screening, the majority (98.3%) had at least one risk factor. Regardless of gender, the number of risk factors was significantly positively correlated with the mean CAC score (p<0.0001). Overall, the mean CAC score was 93.1, 183.4, and 405.7 for those with <3, 3-5, and >5 risk factors, respectively (p<0.0001). After adjusting for gender and age, clusters of 3-5 and >5 risk factors were significantly associated with increased odds of having CAC by approximately two times [OR=1.92; 95% CI (1.52-2.42)] and six times [OR=6.12, 95% CI (3.05-12.29)], respectively.
Conclusion: Among this rural population, the number of clusters of risk factors was positively associated with higher CAC scores. This may indicate that the number of risk factors may help in determining the severity of CAD in this population before it progresses further to the extent when individuals develop symptoms or have cardiovascular events. This suggests the importance of primary prevention by aggressive risk factors modification for preventing future CAD and subsequent coronary events in these asymptomatic individuals.
Learning Areas:Basic medical science applied in public health
Chronic disease management and prevention
Evaluate the correlations between risk factors and coronary artery calcium (CAC) scores Determine the clustering of the risk factors across age and gender
Keyword(s): Risk Factors/Assesment, Rural Health
Qualified on the content I am responsible for because: I am part on a CVD research group that conduct studies on coronary artery calcium (CAC) using populations in Central Appalachia.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.