Skip to main content
Erschienen in: The International Journal of Cardiovascular Imaging 2/2013

01.02.2013 | Original Paper

Non-invasive assessments reveal that more than half of randomly selected middle-aged individuals have evidence of subclinical atherosclerosis: a DanRisk substudy

verfasst von: Ida S. Bjerrum, Niels P. Rønnow Sand, Mikael K. Poulsen, Bjarne L. Nørgaard, Johannes J. Sidelmann, Allan Johansen, Hans Mickley, Axel C. P. Diederichsen

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

Screening of the general population for subclinical atherosclerosis is controversial. We assessed the prevalence of subclinical atherosclerosis in healthy middle-aged individuals by 4 non-invasive modalities. In 277 randomly selected males (n = 121) and females (n = 156), aged 50 or 60 years, without known cardiovascular disease or diabetes, intima-media thickness/presence of carotid plaques by ultrasound; coronary artery calcification (CAC) by non-contrast enhanced cardiac CT; occurrence of peripheral artery disease (PAD) by ankle brachial index (ABI), and vascular leakage by urine albumin creatinine ratio (ACR), were evaluated. Traditional risk factors were obtained and HeartScore was calculated. A total of 56 % had morphological signs of atherosclerosis in one of the vascular territories; 41 % had CAC and 31 % a carotid plaque. Among individuals with atherosclerosis, 28 % had lesions in both vascular territories. Subclinical atherosclerosis was significantly more frequent in older males. Signs of PAD and microalbuminuria were very uncommon and detected in only 1 % of the entire population. No association was found between morphological signs of subclinical atherosclerosis and ABI or ACR. More than half of randomly selected apparently healthy middle aged individuals had subclinical atherosclerosis located in the coronary or carotid arteries.
Literatur
1.
Zurück zum Zitat Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM et al (2011) Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation 123(4):e18–e209PubMedCrossRef Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM et al (2011) Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation 123(4):e18–e209PubMedCrossRef
2.
Zurück zum Zitat Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847PubMedCrossRef Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847PubMedCrossRef
3.
Zurück zum Zitat Conroy RM, Pyorala K, Fitzgerald AP, Sans S, Menotti A, De BG et al (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24(11):987–1003PubMedCrossRef Conroy RM, Pyorala K, Fitzgerald AP, Sans S, Menotti A, De BG et al (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24(11):987–1003PubMedCrossRef
4.
Zurück zum Zitat Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R et al (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts). Eur Heart J 28(19):2375–2414PubMedCrossRef Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R et al (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts). Eur Heart J 28(19):2375–2414PubMedCrossRef
5.
Zurück zum Zitat Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA et al (2010) ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 122(25):2748–2764PubMedCrossRef Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA et al (2010) ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 122(25):2748–2764PubMedCrossRef
6.
Zurück zum Zitat Erbel R, Mohlenkamp S, Moebus S, Schmermund A, Lehmann N, Stang A et al (2010) Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: the Heinz Nixdorf Recall study. J Am Coll Cardiol 56(17):1397–1406PubMedCrossRef Erbel R, Mohlenkamp S, Moebus S, Schmermund A, Lehmann N, Stang A et al (2010) Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: the Heinz Nixdorf Recall study. J Am Coll Cardiol 56(17):1397–1406PubMedCrossRef
7.
Zurück zum Zitat Melander O, Newton-Cheh C, Almgren P, Hedblad B, Berglund G, Engstrom G et al (2009) Novel and conventional biomarkers for prediction of incident cardiovascular events in the community. JAMA 302(1):49–57PubMedCrossRef Melander O, Newton-Cheh C, Almgren P, Hedblad B, Berglund G, Engstrom G et al (2009) Novel and conventional biomarkers for prediction of incident cardiovascular events in the community. JAMA 302(1):49–57PubMedCrossRef
8.
Zurück zum Zitat Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 115(4):459–467PubMedCrossRef Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 115(4):459–467PubMedCrossRef
9.
Zurück zum Zitat Polonsky TS, McClelland RL, Jorgensen NW, Bild DE, Burke GL, Guerci AD, Greenland P (2010) Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA 303(16):1610–1616PubMedCrossRef Polonsky TS, McClelland RL, Jorgensen NW, Bild DE, Burke GL, Guerci AD, Greenland P (2010) Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA 303(16):1610–1616PubMedCrossRef
10.
Zurück zum Zitat Fowkes FG, Murray GD, Butcher I, Heald CL, Lee RJ, Chambless LE et al (2008) Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA 300(2):197–208PubMedCrossRef Fowkes FG, Murray GD, Butcher I, Heald CL, Lee RJ, Chambless LE et al (2008) Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA 300(2):197–208PubMedCrossRef
11.
Zurück zum Zitat Mancia G, De BG, Dominiczak A, Cifkova R, Fagard R, Germano G et al (2007) Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 25(6):1105–1187PubMedCrossRef Mancia G, De BG, Dominiczak A, Cifkova R, Fagard R, Germano G et al (2007) Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 25(6):1105–1187PubMedCrossRef
12.
Zurück zum Zitat Diederichsen AC, Sand NP, Norgaard B, Lambrechtsen J, Jensen JM, Munkholm H et al (2012) Discrepancy between coronary artery calcium score and HeartScore in middle-aged Danes: the DanRisk study. Eur J Prev Cardiol 19(3):558–564PubMedCrossRef Diederichsen AC, Sand NP, Norgaard B, Lambrechtsen J, Jensen JM, Munkholm H et al (2012) Discrepancy between coronary artery calcium score and HeartScore in middle-aged Danes: the DanRisk study. Eur J Prev Cardiol 19(3):558–564PubMedCrossRef
13.
Zurück zum Zitat Stein JH, Korcarz CE, Post WS (2009) Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: summary and discussion of the American Society of Echocardiography consensus statement. Prev Cardiol 12(1):34–38PubMedCrossRef Stein JH, Korcarz CE, Post WS (2009) Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: summary and discussion of the American Society of Echocardiography consensus statement. Prev Cardiol 12(1):34–38PubMedCrossRef
14.
Zurück zum Zitat Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832PubMedCrossRef Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832PubMedCrossRef
15.
Zurück zum Zitat Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL et al (2006) ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the american association for vascular surgery/society for vascular surgery, society for cardiovascular angiography and interventions, society for vascular medicine and biology, society of interventional radiology, and the ACC/AHA task force on practice guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 113(11):e463–e654PubMedCrossRef Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL et al (2006) ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the american association for vascular surgery/society for vascular surgery, society for cardiovascular angiography and interventions, society for vascular medicine and biology, society of interventional radiology, and the ACC/AHA task force on practice guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 113(11):e463–e654PubMedCrossRef
16.
Zurück zum Zitat Folsom AR, Kronmal RA, Detrano RC, O’Leary DH, Bild DE, Bluemke DA et al (2008) Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med 168(12):1333–1339PubMedCrossRef Folsom AR, Kronmal RA, Detrano RC, O’Leary DH, Bild DE, Bluemke DA et al (2008) Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med 168(12):1333–1339PubMedCrossRef
17.
Zurück zum Zitat Bauer M, Mohlenkamp S, Lehmann N, Schmermund A, Roggenbuck U, Moebus S et al (2009) The effect of age and risk factors on coronary and carotid artery atherosclerotic burden in males-results of the Heinz Nixdorf Recall Study. Atherosclerosis 205(2):595–602PubMedCrossRef Bauer M, Mohlenkamp S, Lehmann N, Schmermund A, Roggenbuck U, Moebus S et al (2009) The effect of age and risk factors on coronary and carotid artery atherosclerotic burden in males-results of the Heinz Nixdorf Recall Study. Atherosclerosis 205(2):595–602PubMedCrossRef
18.
Zurück zum Zitat Karim R, Hodis HN, Detrano R, Liu CR, Liu CH, Mack WJ (2008) Relation of Framingham risk score to subclinical atherosclerosis evaluated across three arterial sites. Am J Cardiol 102(7):825–830PubMedCrossRef Karim R, Hodis HN, Detrano R, Liu CR, Liu CH, Mack WJ (2008) Relation of Framingham risk score to subclinical atherosclerosis evaluated across three arterial sites. Am J Cardiol 102(7):825–830PubMedCrossRef
19.
Zurück zum Zitat Criqui MH, Kamineni A, Allison MA, Ix JH, Carr JJ, Cushman M et al (2010) Risk factor differences for aortic versus coronary calcified atherosclerosis: the multiethnic study of atherosclerosis. Arterioscler Thromb Vasc Biol 30(11):2289–2296PubMedCrossRef Criqui MH, Kamineni A, Allison MA, Ix JH, Carr JJ, Cushman M et al (2010) Risk factor differences for aortic versus coronary calcified atherosclerosis: the multiethnic study of atherosclerosis. Arterioscler Thromb Vasc Biol 30(11):2289–2296PubMedCrossRef
20.
Zurück zum Zitat Oei HH, Vliegenthart R, Hak AE, del Iglesias SA, Hofman A, Oudkerk M, Witteman JC (2002) The association between coronary calcification assessed by electron beam computed tomography and measures of extracoronary atherosclerosis: the Rotterdam Coronary Calcification Study. J Am Coll Cardiol 39(11):1745–1751PubMedCrossRef Oei HH, Vliegenthart R, Hak AE, del Iglesias SA, Hofman A, Oudkerk M, Witteman JC (2002) The association between coronary calcification assessed by electron beam computed tomography and measures of extracoronary atherosclerosis: the Rotterdam Coronary Calcification Study. J Am Coll Cardiol 39(11):1745–1751PubMedCrossRef
21.
Zurück zum Zitat Naqvi TZ, Mendoza F, Rafii F, Gransar H, Guerra M, Lepor N et al (2010) High prevalence of ultrasound detected carotid atherosclerosis in subjects with low Framingham risk score: potential implications for screening for subclinical atherosclerosis. J Am Soc Echocardiogr 23(8):809–815PubMedCrossRef Naqvi TZ, Mendoza F, Rafii F, Gransar H, Guerra M, Lepor N et al (2010) High prevalence of ultrasound detected carotid atherosclerosis in subjects with low Framingham risk score: potential implications for screening for subclinical atherosclerosis. J Am Soc Echocardiogr 23(8):809–815PubMedCrossRef
22.
Zurück zum Zitat de Maat MP, Bladbjerg EM, Drivsholm T, Borch-Johnsen K, Moller L, Jespersen J (2003) Inflammation, thrombosis and atherosclerosis: results of the Glostrup study. J Thromb Haemost 1(5):950–957PubMedCrossRef de Maat MP, Bladbjerg EM, Drivsholm T, Borch-Johnsen K, Moller L, Jespersen J (2003) Inflammation, thrombosis and atherosclerosis: results of the Glostrup study. J Thromb Haemost 1(5):950–957PubMedCrossRef
23.
Zurück zum Zitat Howard G, Sharrett AR, Heiss G, Evans GW, Chambless LE, Riley WA, Burke GL (1993) Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke 24(9):1297–1304PubMedCrossRef Howard G, Sharrett AR, Heiss G, Evans GW, Chambless LE, Riley WA, Burke GL (1993) Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke 24(9):1297–1304PubMedCrossRef
24.
Zurück zum Zitat Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH et al (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49(18):1860–1870PubMedCrossRef Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH et al (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49(18):1860–1870PubMedCrossRef
25.
Zurück zum Zitat Becker CR, Kleffel T, Crispin A, Knez A, Young J, Schoepf UJ et al (2001) Coronary artery calcium measurement: agreement of multirow detector and electron beam CT. AJR Am J Roentgenol 176(5):1295–1298PubMed Becker CR, Kleffel T, Crispin A, Knez A, Young J, Schoepf UJ et al (2001) Coronary artery calcium measurement: agreement of multirow detector and electron beam CT. AJR Am J Roentgenol 176(5):1295–1298PubMed
26.
Zurück zum Zitat Callister TQ, Raggi P, Cooil B, Lippolis NJ, Russo DJ (1998) Effect of HMG-CoA reductase inhibitors on coronary artery disease as assessed by electron-beam computed tomography. N Engl J Med 339(27):1972–1978PubMedCrossRef Callister TQ, Raggi P, Cooil B, Lippolis NJ, Russo DJ (1998) Effect of HMG-CoA reductase inhibitors on coronary artery disease as assessed by electron-beam computed tomography. N Engl J Med 339(27):1972–1978PubMedCrossRef
27.
Zurück zum Zitat Resnick HE, Lindsay RS, McDermott MM, Devereux RB, Jones KL, Fabsitz RR, Howard BV (2004) Relationship of high and low ankle brachial index to all-cause and cardiovascular disease mortality: the Strong Heart Study. Circulation 109(6):733–739PubMedCrossRef Resnick HE, Lindsay RS, McDermott MM, Devereux RB, Jones KL, Fabsitz RR, Howard BV (2004) Relationship of high and low ankle brachial index to all-cause and cardiovascular disease mortality: the Strong Heart Study. Circulation 109(6):733–739PubMedCrossRef
28.
Zurück zum Zitat Espinola-Klein C, Rupprecht HJ, Bickel C, Lackner K, Savvidis S, Messow CM et al (2008) Different calculations of ankle-brachial index and their impact on cardiovascular risk prediction. Circulation 118(9):961–967PubMedCrossRef Espinola-Klein C, Rupprecht HJ, Bickel C, Lackner K, Savvidis S, Messow CM et al (2008) Different calculations of ankle-brachial index and their impact on cardiovascular risk prediction. Circulation 118(9):961–967PubMedCrossRef
29.
Zurück zum Zitat Shah PK (2010) Screening asymptomatic subjects for subclinical atherosclerosis: can we, does it matter, and should we? J Am Coll Cardiol 56(2):98–105PubMedCrossRef Shah PK (2010) Screening asymptomatic subjects for subclinical atherosclerosis: can we, does it matter, and should we? J Am Coll Cardiol 56(2):98–105PubMedCrossRef
Metadaten
Titel
Non-invasive assessments reveal that more than half of randomly selected middle-aged individuals have evidence of subclinical atherosclerosis: a DanRisk substudy
verfasst von
Ida S. Bjerrum
Niels P. Rønnow Sand
Mikael K. Poulsen
Bjarne L. Nørgaard
Johannes J. Sidelmann
Allan Johansen
Hans Mickley
Axel C. P. Diederichsen
Publikationsdatum
01.02.2013
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 2/2013
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-012-0091-8

Weitere Artikel der Ausgabe 2/2013

The International Journal of Cardiovascular Imaging 2/2013 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.