Clinical Investigations: Congestive Heart FailureAbdominal aortic calcific deposits are associated with increased risk for congestive heart failure: The Framingham Heart Study☆,☆☆,★
Section snippets
Study sample
The Framingham Heart Study is a prospective epidemiologic cohort study that was established in 1948 to evaluate potential risk factors for CHD. The original cohort consisted of 5209 residents of Framingham, Mass, aged 28 to 62 years who have undergone follow-up evaluations every 2 years. The study design and entry criteria have been detailed elsewhere.19 As part of an osteoporosis survey, subjects had lateral lumbar radiographs performed at biennial examination 10 (1966-1970). Subjects with
Baseline characteristics
The clinical characteristics of our study population are summarized in Table II.Variable Males (n = 1030) Females (n = 1437) Age (y) 60.4 ± 7.8 60.8 ± 8.0 Hypertension (%) 24.5 29.0 SBP (mmHg) 138.6 ± 21.6 140.4 ± 24.5 DBP (mmHg) 81.3 ± 11.3 80.1 ± 11.5 Pulse pressure (mmHg) 57.2 ± 16.8 60.3 ± 19.2 Hypertension treatment (%) 11.4 16.7 CHD (%) 14.3 7.4 Diabetes (%) 5.5 4.5 Total cholesterol (mmol/L) 5.7 ± 1.0 6.3 ± 1.1 [mg/dL] [221.3 ± 39.9] [243.3 ± 42.0] HDL
Discussion
In our study, abdominal aortic calcific deposits on lateral lumbar radiographs, a measure of aortic atherosclerosis, were associated with increased risk for CHF, even after multivariable adjustment for CHF risk factors, including CHD, hypertension, diabetes, and electrocardiographic left ventricular hypertrophy. The presence of prevalent or intercurrent CHD did not explain the primary result.
References (44)
- et al.
Predictors of congestive heart failure in the elderly: the Cardiovascular Health Study
J Am Coll Cardiol
(2000) - et al.
Aortic calcification as a predictor of cardiovascular mortality
Lancet
(1986) - et al.
J-shaped relation between change in diastolic blood pressure and progression of aortic atherosclerosis
Lancet
(1994) - et al.
Relation of arterial pressure waveform to left ventricular and carotid anatomy in normotensive subjects
J Am Coll Cardiol
(1993) - et al.
Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance
J Am Coll Cardiol
(2001) - et al.
New indices to classify location, severity and progression of calcific lesions in the abdominal aorta: a 25-year follow-up study
Atherosclerosis
(1997) - et al.
A study of the correlation between roentgenographic and post-mortem calcification of the aorta
Am Heart J
(1954) - et al.
Some methodological problems in the long-term study of cardiovascular disease: observations on the Framingham Study
J Chronic Dis
(1959) - et al.
Reversible ischemic left ventricular dysfunction: evidence for the “hibernating myocardium”
J Am Coll Cardiol
(1986) - et al.
Relation of coronary artery disease to atherosclerotic disease in the aorta, carotid, and femoral arteries evaluated by ultrasound
Am J Cardiol
(1997)
Correlation of noninvasive arterial compliance with anatomic pathology of atherosclerotic nonhuman primates
Atherosclerosis
Correlation of ultrasonic attenuation (30 to 50 MHz) and constituents of atherosclerotic plaque
Ultrasound Med Biol
Evaluation of morphological changes of the atherosclerotic aorta by enhanced computed tomography
Atherosclerosis
Effect of enalapril on myocardial infarction and unstable angina in patients with low ejection fractions
Lancet
The natural history of congestive heart failure: the Framingham study
N Engl J Med
Risk factors for heart failure in the general population: the study of men born in 1913
Eur Heart J
Incidence of heart failure in eastern Finland: a population-based surveillance study
Eur Heart J
Incidence and aetiology of heart failure: a population-based study
Eur Heart J
Lumbar aortic calcification is an important predictor of vascular morbidity and mortality
Circulation
Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease
JAMA
Reversal of atherosis and sclerosis: the two components of atherosclerosis
Circulation
Input impedance as vascular load. McDonald's blood flow in arteries. Theoretical, experimental, and clinical principles
Cited by (94)
Abdominal Aortic Calcification as a Marker of Relationship Between Atherosclerosis and Skeletal Fragility
2020, Journal of Clinical Densitometry
- ☆
Supported by the National Heart, Lung, and Blood Institute Framingham Heart Study, National Institutes of Health (NIH/NHLBI contract N01-HC-38038).
- ☆☆
Reprint requests: Christopher J. O'Donnell, MD, MPH, Framingham Heart Study, 73 Mount Wayte Ave, Suite #2, Framingham, MA 01702.
- ★
E-mail: [email protected]